Patient case (clinical description): A 20-year-old man comes to the emergency due to bleeding after a tooth extraction.  The bleeding has persisted for approximately 30 minutes despite constant direct pressure.  He is a known case of Hemophilia type A treated with FVIII. Blood pressure is 95/60 mm Hg and pulse is 105/min. His weight is 70 Kg. Family history is positive for Hemophilia type A in his maternal uncle. He also has a lipoma on his left arm which he plans to remove surgically. His FVIII activity is 40%.

Patient's own account: I got my tooth extracted and I could not stop bleeding for 30 min. I'm a 20 yo dude but I have Hemophilia type A treated with FVIII. My blood pressure was 95/60 and my pulse 105/min. I'm 70 kg. My uncle on my mom's side also has type A hemophilia. I also have a fatty swelling on my left arm and I was supposed to remove it. My FVIII activity was 40%.

Clinical trial: A Post Approval Commitment Study to Gain More Information on How Safe and Effective KOVALTRY is in Chinese Children, Adolescents /Adults With Severe Hemophilia A

Eligibility criteria:
Inclusion Criteria:

        Part A (PTPs):

          -  Chinese participants with severe hemophilia A (defined as Factor VIII (FVIII): C < 1%
             with one- stage clotting assay documented at the time of screening)

          -  Currently receiving on-demand or any type of prophylaxis treatment regimen with any
             FVIII product

          -  For participants < 12 years of age, ≥ 50 exposure days (ED); for participants ≥ 12 to
             65 years of age, ≥ 150 ED with any FVIII product

          -  No current evidence of inhibitor

          -  No history of FVIII inhibitor formation

          -  Signed informed consent

        Part B (PUPs/MTPs):

          -  Participants must be <6 years of age at the time of their parent or legal
             representative's signature of informed consent on the participant's behalf

          -  Chinese participants with severe hemophilia A (defined as Factor VIII (FVIII): C < 1%
             with one- stage clotting assay documented at the time of screening)

          -  PUPs must have no previous exposure to any FVIII product. MTPs must have no more than
             1 ED with any purified FVIII concentrate or 3 exposures with FFP or cryoprecipitate.

          -  MTPs must have no current evidence of inhibitor antibody as measured by the
             Nijmegen-modified Bethesda assay (<0.6 BU/mL) in 2 consecutive samples and must have
             absence of clinical signs or symptoms of decreased response to FVIII administration.
             Testing for the 2 negative samples must be performed by the central laboratory at
             least 1 week but not more than 2 weeks apart. Participants may not receive FVIII
             product within 72 hours prior to the collection of samples for inhibitor testing.

          -  PUPs and MTPs must observe a 6-month washout period if they have received subcutaneous
             factor substitution therapy (emicizumab).

          -  PUPs may be included if they will receive their first FVIII dose with KOVALTRY for
             treatment of first bleed and agree to start prophylaxis as part of their care. MTPs
             may be included if they agree to start prophylaxis as part of their care.

        Exclusion Criteria:

        Part A (PTPs):

          -  Any other bleeding disease that is different from hemophilia A (e.g. von Willebrand
             disease, hemophilia B)

          -  Platelet count < 100 000/mm^3

          -  Impaired renal function (serum creatinine > 2.0 mg/dL) or active liver disease
             (alanine aminotransferase/aspartate aminotransferase [ALT/AST] > 5x ULN)

          -  Human immunodeficiency virus (HIV) positive with an absolute CD4 lymphocyte cell count
             < 250 cells/μL

          -  Known hypersensitivity to the active substance, mouse or hamster protein

          -  Receiving chemotherapy, immune modulatory drugs other than anti-retroviral
             chemotherapy, or chronic use of oral or intravenous (IV) corticosteroids (> 14 days)
             within the last 3 months.

          -  Requiring any pre-medication to tolerate FVIII infusions (e.g. antihistamines)

          -  Currently participating in another investigational drug study, or having previously
             participated in a clinical study involving an investigational drug within 30 days of
             signing informed consent or participated in completed interventional clinical studies
             with BAY81-8973 (Kovaltry)

          -  Planned major surgery, defined as surgery with respiratory assistance and/or general
             anesthesia

        Part B (PUPs/MTPs):

          -  Any other bleeding disease that is different from hemophilia A (e.g. von Willebrand
             disease, hemophilia B)

          -  Platelet count < 100 000/mm^3

          -  Impaired renal function (serum creatinine >2× upper limit of normal [ULN]) or active
             liver disease (alanine aminotransferase [ALT] or aspartate aminotransferase [AST] >5×
             ULN) based on screening laboratory assessments

          -  MTPs with history of FVIII inhibitor formation

          -  Known hypersensitivity to the active substance, mouse or hamster protein

          -  First treatment with KOVALTRY for high risk bleeding situations (e.g., surgery,
             intracranial bleed) or requiring intensive or prolonged treatment

          -  Receiving chemotherapy, immune modulatory drugs other than anti-retroviral
             chemotherapy, or chronic use of oral or intravenous (IV) corticosteroids (> 14 days)
             within the last 3 months.

          -  Requiring any pre-medication to tolerate FVIII infusions (e.g. antihistamines)

          -  Currently participating in another investigational drug study, or having previously
             participated in a clinical study involving an investigational drug within 30 days of
             signing informed consent or participated in completed interventional clinical studies
             with BAY 81-8973 (Kovaltry)

          -  Planned major surgery, defined as surgery with respiratory assistance and/or general
             anesthesia

          -  Unable to tolerate volume of blood draws required for study participation
Male
No healthy subjects accepted to join the trial.

Subject must be at most 65 Years

Eligibility (NLI label): Contradiction