TREATMENT OF COAGULATION DISEASE BY ADMINISTRATION OF RECOMBINANT VWF
The present invention provides methods of treating coagulation disease, including hemophilia and von Willebrand disease by administering recombinant von Willebrand Factor alone or in combination with Factor VIII.
1 .- 31 . (canceled)
32 . A method for treating Von Willebrand Disease Type 2 or Type 3 comprising administering a Recombinant Von Willebrand Factor (rVWF) to a human subject in need thereof,
wherein the rVWF comprises a high molecular weight VWF multimer composition comprising at least 40% VWF decamers or highly multimeric VWF,
wherein said rVWF is not modified with a water soluble polymer,
wherein endogenous Factor VIII (FVIII) half-life is extended by at least 5 hours as compared to a subject administered plasma derived Von Willebrand Factor (pdVWF), and
wherein rVWF is administered at a lower frequency of treatment compared to a pdVWF, said pdVWF comprising human-derived VWF complexed to FVIII, and
wherein the rVWF administered to the subject provides increased stability for in vivo FVIII as compared to stability resulting from administration of pdVWF.
33 . The method of claim 32 , wherein the rVWF is matured in vitro by treatment with Furin.
34 . The method of claim 32 , wherein the subject is to be administered between 1.0 IU/kg VWF:RCo (von Willebrand factor Ristocetin cofactor activity) and 150 IU/kg VWF:RCo per dose, between 10 IU/kg VWF:RCo (von Willebrand factor Ristocetin cofactor activity) and 125 IU/kg VWF:RCo per dose, between 10 IU/kg VWF:RCo and 50 IU/kg VWF:RCo per dose, between 10 IU/kg VWF:RCo and 40 IU/kg VWF:RCo per dose, between 10 IU/kg VWF:RCo and 20 IU/kg VWF:RCo per dose, between 25 IU/kg VWF:RCo and 125 IU/kg VWF:RCo per dose, or between 25 IU/kg VWF:RCo and 75 IU/kg VWF:RCo per dose.
35 . The method of claim 32 , wherein the rVWF comprises ultra-large multimers (ULMs), wherein the ULMs comprise multimers that comprise over 40 subunits and are at least 10,000 kDa,
36 . The method of claim 32 , wherein the rVWF has a specific activity of about 20 to 150 mU/μg, or wherein the rVWF has a specific activity of about 30 to 120 mU/μg.
37 . The method of claim 32 , wherein the high molecular weight VWF multimer composition comprises at least 50% VWF decamers or highly multimeric VWF, at least 60% VWF decamers or highly multimeric VWF, or at least 70% VWF decamers or highly multimeric VWF.
38 . The method of claim 32 , wherein the rVWF is administered no more than once daily, no more than once every other day, no more than once every third day, no more than once every fourth day, no more than once every fifth day, no more than twice a week, no more than once a week, no more than once every two weeks, or no more than once a month.
39 . The method of claim 32 , wherein the rVWF is administered in multiple administrations.
40 . The method of claim 32 , wherein the rVWF is produced through expression in a Chinese Hamster Ovary (CHO) cell culture.
41 . The method of claim 32 , further comprising administering rFVIII.
42 . The method of claim 41 , wherein the rFVIII and rVWF are produced through expression in the same cell culture.
43 . The method of claim 41 , wherein the rVWF and rFVIII are administered together in a single composition.
44 . The method of claim 41 , wherein the rVWF and rFVIII are administered together in an initial dose and then subsequent re-dosing is conducted with rVWF alone.
45 . The method of claim 43 or 44 , wherein the ratio of rFVIII procoagulant activity (IU FVIII:C) to rVWF Ristocetin cofactor activity (IU rVWF:RCo) to be administered to the subject is between 3:2 and 1:3.
46 . The method of claim 43 or 44 , wherein the ratio of rFVIII procoagulant activity (IU FVIII:C) to rVWF Ristocetin cofactor activity (IU rVWF:RCo) to be administered to the subject is between 1:1 and 1:2.
47 . The method of claim 43 or 44 , wherein the ratio of rFVIII procoagulant activity (IU FVIII:C) to rVWF Ristocetin cofactor activity (IU rVWF:RCo) to be administered to the subject is about 3:4.