Health-related quality of life in adults with hemophilia B after gene therapy with fidanacogene elaparvovec: results from the BENEGENE-2 trial.

PMID 41110511 | DOI 10.1016/j.jtha.2025.09.029 · Journal of thrombosis and haemostasis : JTH · 2026 · View on PubMed ↗

BACKGROUND: BENEGENE-2 is an ongoing phase 3 trial of fidanacogene elaparvovec, an adeno-associated virus gene therapy vector delivering a high-activity factor (F)IX variant, FIX-R338L (FIX-Padua). OBJECTIVES: To assess patient-reported outcome measures in BENEGENE-2. METHODS: Eligible males (N = 45) with hemophilia B received a single fidanacogene elaparvovec infusion after ≥6 months of FIX prophylaxis. Participants completed assessments pre- and post-gene therapy, including the Hemophilia Quality of Life Questionnaire for Adults (Haem-A-QoL), Hemophilia Activities List (HAL), Patient Global Impression of Change-Hemophilia, Hemophilia Life Impacts Questionnaire, and European Quality of Life 5-Dimensions 5-levels. RESULTS: Post-gene therapy, more participants (64.4% vs 28.9%) were free from bleeds compared with pre-gene therapy. Overall, 64.4% of participants did not require exogenous FIX infusions post-gene therapy. Changes from pre- to week 52 post-gene therapy suggested improved health-related quality of life in the key secondary endpoints of the Haem-A-QoL Physical Health domain (mean [SD] score change, -7.7 [15.8]; P = .005) and the HAL Complex Lower Extremity Activities score (mean [SD] score change, 7.6 [19.6]; P = .024). Additionally, there was a mean (SD) improvement of -11.2 (9.1), P < .001, in the Haem-A-QoL total score, and 6.7 (10.9), P < .001, in the HAL total score. In the exploratory endpoints, changes in the European Quality of Life 5-Dimensions 5-levels index score (mean [SD] score change, 0.05 [0.10]; P = .003) and visual analog scale (mean [SD] score change, 5.8 [15.6]; P = .030) suggested improved health status. Overall, 56.1% of participants reported that their overall impression of life with hemophilia (Patient Global Impression of Change-Hemophilia) had "greatly improved." Improvements were observed in Hemophilia Life Impacts Questionnaire domains related to living with and treating hemophilia. CONCLUSION: Fidanacogene elaparvovec improved health-related quality of life and health and functional status in adults with hemophilia B.