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Table 1 A table summarising the currently available extended half-life products, including their mechanism of half-life prolongation, terminal half-life, ratio of terminal half-life compared with standard factor, and their licensing status in the United States and European Union

From: Advances in the management of haemophilia: emerging treatments and their mechanisms

EHL product Generic name Mechanism of action Half-life of EHL product (hours) Half-life of standard factor
(hours)
Ratio (EHL to standard factor half-life) Licensing status Frequency of administration Comments and notable points
FVIII extended half-life products for use in Haemophilia A
Lonoctocog alfa pegol Afstyla B-domain truncated single chain 14.5 13.3 1.1 Licensed Every second day Only modest improvement in half-life thus requiring more frequent administration than other EHLs
Efmoroctocog alfa Elocta FVIII Fc fusion protein 19.0 12.4 1.5 Licensed Effective with once-weekly administration  
Damoctocog alfa pegol Jivi PEGylated B-domain deleted FVIII 18.5 13.0 1.4 Licensed Once weekly administration possible Not licensed for use in children under 12
Rurioctocog alfa pegol Adynovi PEGylated FVIII 14.3 10.4 1.4 Licensed Twice weekly or less
Turoctocog alfa pegol NovoEight PEGylated B-domain truncated FVIII 19.5 13.0 1.5 Licensed Every 4–7 days Can be used in all age groups, including under 12 years
FIX extended half-life products for use in Haemophilia B
Nonacog beta pegol Refixia PEGylated B-domain truncated FIX 92.7 17.8 5.2 Licensed Currently licenced for administration every 3–4 days Not licensed for use in children under 12
Albutrepenonacog alfa Idelvion FIX albumin fusion protein 92.0 17.0 5.4 Licensed Administration up to once every 14 days (up to 7 days in children)  
Eftrenonacog alfa Alprolix FIX Fc fusion protein 82.1 33.8 2.4 Licensed Once every 7–10 days in all age groups  
Dalcinonacog alfa N/A rFIX with 3 amino acid mutations 106.9 21.0 5.1 Phase IIb Currently once daily The only EHL currently to offer subcutaneous administration
  1. Information regarding their administration frequencies along with any notable points regarding individual EHLs are also provided
  2. EHL extended half-life; FVIII factor VIII; FIX factor IX