Volume 11 (2024): Issue 1

A single centre experience with clinical use of Neria™ Guard as mode of pain and distress management in the administration of emicizumab in children

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Maj Friberg Birkedal ORCID iD

Abstract

Abstract Background

The introduction of emicizumab as prophylactic subcutaneous (SC) administered treatment for people with haemophilia A has revolutionised its treatment and care; SC injection and the infrequent treatment intervals that can be achieved with emicizumab reduces treatment burden and interference in daily life. The efficacy and safety of emicizumab have been investigated in the Haven 1-7 trials. In contrast to the 4% of enrolled patients experiencing pain at the injection site across all seven trials, 11 out of 16 families at our treatment centre reported pain-related distress in administering emicizumab to their children, despite the application of local analgesia.

Aim

The study aimed to retrospectively evaluate whether using the Neria™ Guard infusion set, a single-use medical device for SC drug delivery that allows for slow infusion, reduced pain and distress in children receiving emicizumab.

Methods

This single-centre retrospective study included 11 paediatric patients whose families were introduced to the Neria™ Guard infusion set with the intent of reducing pain and distress. Plasma emicizumab values were tested after the introduction in relation to routine clinical check-ups in all patients. Data was collected retrospectively from patient files. According to local regulations ethical approval and consent was not necessary.

Results

Parents/caregivers had no difficulty learning how to use the system; a single demonstration was sufficient in all cases. All families reported a reduction or complete resolution of pain and distress in relation to emicizumab injection after the introduction of Neria™ Guard, and all families have continued using the device. Plasma levels of emicizumab were sustained within the target therapeutic range.

Conclusion

There is a need for more recognition of and research into the prevalence of pain and distress among children receiving treatment with emicizumab, and a need for a validated and stability tested solution to alleviate this. Neria™ Guard has proven to be effective in the reduction of pain and distress in our clinic.

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