Simoctocog alfa (Nuwiq®) in previously untreated patients with severe haemophilia A-Final efficacy and safety results from the NuProtect study.

INTRODUCTION: Simoctocog alfa (Nuwiq®) is a 4th generation recombinant FVIII with proven efficacy for the prevention and treatment of bleeding episodes (BEs) in previously treated patients with severe haemophilia A. The NuProtect study assessed the immunogenicity, efficacy and safety of simoctocog alfa in 108 previously untreated patients (PUPs). The incidence of high-titre inhibitors was 16.2% and no patients with non-null F8 mutations developed inhibitors. AIM: To report the efficacy and safety results from the NuProtect study. METHODS: PUPs received simoctocog alfa for prophylaxis, treatment of BEs, or as surgical prophylaxis. The efficacy of prophylaxis (during inhibitor-free periods) was assessed using annualised bleeding rates (ABRs). The efficacy in treating BEs and in surgical prophylaxis was assessed using a 4-point scale. Adverse events were recorded throughout the study. RESULTS: Of 108 PUPs treated with simoctocog alfa, 103 received at least one prophylactic dose and 50 received continuous prophylaxis for at least 24 weeks. In patients on continuous prophylaxis, the median ABR was 0 (mean 0.5) for spontaneous BEs and 2.5 (mean 3.6) for all BEs. In 85 patients who had BEs, efficacy of BE treatment was excellent or good for 92.9% (747/804) of rated BEs; 92.3% of BEs were treated with 1 or 2 infusions. The efficacy of surgical prophylaxis was excellent or good for 94.7% (18/19) of rated procedures. There were no safety concerns and no thromboembolic events. CONCLUSION: Simoctocog alfa was efficacious and well tolerated as prophylaxis, surgical prophylaxis and for the treatment of BEs in PUPs with severe haemophilia A.

Grain growth of NpO2 and UO2 nanocrystals.

We report on the crystallite growth of nanometric NpO2 and UO2 powders. The AnO2 nanoparticles (An = U and Np) were synthesized by hydrothermal decomposition of the corresponding actinide(iv) oxalates. NpO2 powder was isothermally annealed between 950 °C and 1150 °C and UO2 between 650 °C and 1000 °C. The crystallite growth was then followed by high-temperature X-ray diffraction (HT-XRD). The activation energies for the growth of crystallites of UO2 and NpO2 were determined to be 264(26) kJ mol-1 and 442(32) kJ mol-1, respectively, with a growth exponent n = 4. The value of the exponent n and the low activation energy suggest that the crystalline growth is rate-controlled by the mobility of the pores, which migrate by atomic diffusion along the pore surfaces. We could thus estimate the cation self-diffusion coefficient along the surface in UO2, NpO2 and PuO2. While data for surface diffusion coefficients for NpO2 and PuO2 are lacking in the literature, the comparison with literature data for UO2 supports further the hypothesis of a surface diffusion controlled growth mechanism.

Synthesis of Nanocrystalline PuO2 by Hydrothermal and Thermal Decomposition of Pu(IV) Oxalate: A Comparative Study.

In recent years, the hydrothermal conversion of actinide (IV) oxalates into nanometric actinide dioxides (AnO2) has begun to be investigated as an alternative to the widely implemented thermal decomposition method. We present here a comparison between the hydrothermal and the conventional thermal decomposition of Pu(IV) oxalate in terms of particle size, morphology and residual carbon content. A parametric study was carried out in order to define the temperature and time applied in the hydrothermal conversion of tetravalent Pu-oxalate into PuO2 and to optimize the reaction conditions.

Synthesis and characterization of homogeneous (U,Am)O2 and (U,Pu,Am)O2 nanopowders.

This paper details the first dedicated production of homogeneous nanocrystalline particles of mixed actinide oxide solid solutions containing americium. The target compositions were U0.75Pu0.20Am0.05O2, U0.90Am0.10O2 and U0.80Am0.20O2. After successful hydrothermal synthesis and chemical characterisation, the nanocrystals were sintered and their structure and behaviour under self-irradiation were studied by powder XRD. Cationic charge distribution of the as-prepared nanocrystalline and sintered U0.80Am0.20O2 materials was investigated applying U M4 and Am M5 edge high energy resolution XANES (HR-XANES). Typical oxidation states detected for the cations are U(iv)/U(v) and Am(iii)/Am(iv). The measured crystallographic swelling was systematically smaller for the as-synthesised nanoparticles than the sintered products. For sintered pellets, the maximal volumetric swelling was about 0.8% at saturation, in line with literature data for PuO2, AmO2, (U,Pu)O2 or (U,Am)O2.

Covalent bond shortening and distortion induced by pressurization of thorium, uranium, and neptunium tetrakis aryloxides.

Covalency involving the 5f orbitals is regularly invoked to explain the reactivity, structure and spectroscopic properties of the actinides, but the ionic versus covalent nature of metal-ligand bonding in actinide complexes remains controversial. The tetrakis 2,6-di-tert-butylphenoxide complexes of Th, U and Np form an isostructural series of crystal structures containing approximately tetrahedral MO4 cores. We show that up to 3 GPa the Th and U crystal structures show negative linear compressibility as the OMO angles distort. At 3 GPa the angles snap back to their original values, reverting to a tetrahedral geometry with an abrupt shortening of the M-O distances by up to 0.1 Å. The Np complex shows similar but smaller effects, transforming above 2.4 GPa. Electronic structure calculations associate the M-O bond shortening with a change in covalency resulting from increased contributions to the M-O bonding by the metal 6d and 5f orbitals, the combination promoting MO4 flexibility at little cost in energy.

Competing Metal-Ligand Interactions in Tris(cyclopentadienyl)-cyclohexylisonitrile Complexes of Trivalent Actinides and Lanthanides.

The structure and bonding properties of 16 complexes formed by trivalent f elements (M=U, Np, Pu and lanthanides except for Pm and Pr) with cyclopentadienyl (Cp) and cyclohexylisonitrile (C≡NCy) ligands, (Cp)3M(C≡NCy), were studied by a joint experimental (XRD, NMR) and theoretical (DFT) analysis. For the large La(III) ion, the bis-adduct (Cp)3La(C≡NCy)2 could also be synthesized and characterized. The metal-ligand interactions, focusing on the comparison of the actinides and lanthanides as well as on the competition of the two different ligands for M, were elucidated using the Quantum Theory of Atoms in Molecules (QTAIM) and Natural Bond Orbital (NBO) models. The results point to interactions of comparable strengths with the anionic Cp and neutral C≡NCy ligands in the complexes. The structural and bonding properties of the actinide complexes reflect small but characteristic differences with respect to the lanthanide analogues. They include larger ligand-to-metal charge transfers as well as metal-ligand electron-sharing interactions. The most significant experimental marker of these covalent interactions is the C≡N stretching frequency.

Immune Tolerance Induction (ITI) with a pdFVIII/VWF Concentrate (octanate) in 100 Patients in the Observational ITI (ObsITI) Study.

Background Immune tolerance induction (ITI) with repeated factor VIII (FVIII) administration is the only strategy proven to eradicate inhibitors. The observational ITI study is evaluating ITI with a range of FVIII products. Methods This subgroup analysis reports prospective interim data for patients treated with a plasma-derived, von Willebrand factor-stabilized FVIII concentrate (pdFVIII/VWF, octanate). Complete success (CS) of ITI required achievement of three criteria: inhibitor titer < 0.6 BU/mL; FVIII recovery ≥ 66%; FVIII half-life ≥6 hours. Partial success (PS) required achievement of two criteria and partial response (PR) one. ITI success was defined as CS or PS. Data were analyzed for patients who achieved CS, had 36 months' observation, or failed ITI. Results One-hundred prospectively enrolled patients were included in the analysis; 91 had poor prognosis factors for ITI success. The mean (standard deviation) daily ITI dose was 116.4 (61.1) IU FVIII/kg in 14 low responders (< 5 BU/mL) and 173.7 (112.0) IU FVIII/kg in 86 high responders (≥ 5 BU/mL). Inhibitor titers < 0.6 BU/mL were achieved in 71% of patients in a median of 4.01 months, accompanied by a 93% reduction in bleeding rate. ITI success was achieved by 70% of patients and 56 of 72 (78%) primary (first-line) ITI patients. PR was achieved by 5 patients; ITI failed in 25 patients. PS and CS were achieved in a median of 5.55 and 11.25 months, respectively. Conclusions ITI with pdFVIII/VWF led to rapid eradication of FVIII inhibitors, normalization of FVIII pharmacokinetics in the majority of patients, and a significant reduction in bleeding rates.

Crystal Structure and Stability in Aqueous Solutions of Na0.5[NpO2(OH)1.5]·0.5H2O and Na[NpO2(OH)2].

The ternary neptunium(V) (Np(V)) hydroxides Na0.5[NpO2(OH)1.5]·0.5H2O (I) and Na[NpO2(OH)2] (II) were synthesized in aqueous NaOH solutions at T = 80 °C, and their crystal structures were determined to be monoclinic, P21, Z = 2, a = 5.9859(2), b = 10.1932(3), c = 12.1524(4) Å, ß = 98.864(1)°, V = 732.63(4) Å3 for (I) and orthorhombic, P212121, Z = 4, a = 5.856(7), b = 7.621(9), c = 8.174(9) Å, V = 364.8(7) Å3 for (II). By combining the detailed structural information with results from systematic solubility investigations, a comprehensive chemical and thermodynamic model of the Np(V) behavior in NaCl-NaOH solutions was evaluated. The results reveal a great stability of the ternary Na-Np(V)-OH solid phases that significantly enhances the predominance field of the entire Np(V) redox state to high alkalinity.

A terminal neptunium(V)-mono(oxo) complex.

Neptunium was the first actinide element to be artificially synthesized, yet, compared with its more famous neighbours uranium and plutonium, is less conspicuously studied. Most neptunium chemistry involves the neptunyl di(oxo)-motif, and transuranic compounds with one metal-ligand multiple bond are rare, being found only in extended-structure oxide, fluoride or oxyhalide materials. These combinations stabilize the required high oxidation states, which are otherwise challenging to realize for transuranic ions. Here we report the synthesis, isolation and characterization of a stable molecular neptunium(V)-mono(oxo) triamidoamine complex. We describe a strong Np≡O triple bond with dominant 5f-orbital contributions and σu > πu energy ordering, akin to terminal uranium-nitrides and di(oxo)-actinyls, but not the uranium-mono(oxo) triple bonds or other actinide multiple bonds reported so far. This work demonstrates that molecular high-oxidation-state transuranic complexes with a single metal-ligand bond can be stabilized and studied in isolation.

Oxidation of Micro- and Nanograined UO2 Pellets by In Situ Synchrotron X-ray Diffraction.

When in contact with oxidizing media, UO2 pellets used as nuclear fuel may transform into U4O9, U3O7, and U3O8. The latter starts forming by stress-induced phase transformation only upon cracking of the pristine U3O7 and is associated with a 36% volumetric expansion with respect to the initial UO2. This may pose a safety issue for spent nuclear fuel (SNF) management as it could imply a confinement failure and hence dispersion of radionuclides within the environment. In this work, UO2 with different grain sizes (representative of the grain size in different radial positions in the SNF) was oxidized in air at 300 °C, and the oxidation mechanisms were investigated using in situ synchrotron X-ray diffraction. The formation of U3O8 was detected only in UO2 pellets with larger grains (3.08 ± 0.06 µm and 478 ± 17 nm), while U3O8 did not develop in sintered UO2 with a grain size of 163 ± 9 nm. This result shows that, in dense materials, a sufficiently fine microstructure inhibits both the cracking of U3O7 and the subsequent formation of U3O8. Hence, the nanostructure prevents the material from undergoing significant volumetric expansion. Considering that the peripheral region of SNF is constituted by the high burnup structure, characterized by 100-300 nm-sized grains and micrometric porosity, these findings are relevant for a better understanding of the spent nuclear fuel behavior and hence for the safety of the nuclear waste storage.

HERFD-XANES and RIXS Study on the Electronic Structure of Trivalent Lanthanides across a Series of Isostructural Compounds.

We performed a systematic study of the complexes of trivalent lanthanide cations with the hydridotris(1-pyrazolyl)borato (Tp) ligand (LnTp3; Ln = La, Ce, Pr, Nd, Sm, Eu, Tb, Dy, Ho, Er, Tm, Yb, and Lu) using both high-energy-resolution fluorescence-detected X-ray absorption near-edge structure (HERFD-XANES) and resonant inelastic X-ray scattering (RIXS) at the lanthanide L3 absorption edge. Here, we report the results obtained and we discuss them against calculations performed using density functional theory (DFT) and atomic multiplet theory. The spectral shape and the elemental trends observed in the experimental HERFD-XANES spectra are well reproduced by DFT calculations, while the pre-edge energy interval is better described by atomic multiplet theory. The RIXS data show a generally rather complex pattern that originates from the intra-atomic electron-electron interactions in the intermediate and final states, as demonstrated by the good agreement obtained with calculations using an atomic-only model of the absorber. Guided by theoretical predictions, we discuss the possible origins of the observed spectral features and the trends in energy splitting across the series. The insight into the electronic structure of trivalent lanthanide compounds demonstrated here and obtained with advanced X-ray spectroscopies coupled with theoretical calculations can be applied to any lanthanide-bearing compound and be of great interest for all research fields involving lanthanides.

Charge Distribution in U1-xCexO2+y Nanoparticles.

In view of safe management of the nuclear wastes, a sound knowledge of the atomic-scale properties of U1-xMxO2+y nanoparticles is essential. In particular, their cation valences and oxygen stoichiometries are of great interest as these properties drive their diffusion and migration behaviors into the environment. Here, we present an in-depth study of U1-xCexO2+y, over the full compositional domain, by combining X-ray diffraction and high-energy resolution fluorescence detection X-ray absorption near-edge structure. We show, on one hand, the coexistence of UIV, UV, and UVI and, on the other hand, that the fluorite structure is maintained despite this charge distribution.

Simoctocog Alfa (Nuwiq) in Previously Untreated Patients with Severe Haemophilia A: Final Results of the NuProtect Study.

INTRODUCTION: FVIII inhibitor development is the most serious contemporary treatment complication in haemophilia A, particularly in previously untreated patients (PUPs). No inhibitors developed in clinical trials in previously treated patients treated with simoctocog alfa (Nuwiq), a fourth-generation recombinant FVIII produced in a human cell line. METHODS: The NuProtect study investigated the immunogenicity of simoctocog alfa in PUPs. NuProtect was a prospective, multinational, open-label, non-controlled, phase III study. PUPs with severe haemophilia A (FVIII:C <1%) of any age and ethnicity were treated with simoctocog alfa for 100 exposure days or a maximum of 5 years. Patients were true PUPs without prior exposure to FVIII concentrates or blood components. Inhibitor titres were measured with the Nijmegen-modified Bethesda assay; cut-off for positivity was 0.6 BU mL-1 (≥0.6 to <5 low-titre, ≥5 high titre). RESULTS: A total of 108 PUPs with a median age at first treatment of 12.0 months (interquartile range: 8.0-23.5) were treated with simoctocog alfa. F8 mutation type was known for 102 patients (94.4%) of whom 90 (88.2%) had null F8 mutations and 12 (11.8%) had non-null mutations. Of 105 PUPs evaluable for inhibitor development, 28 (26.7%) developed inhibitors; 17 high titre (16.2%) and 11 low titre (10.5%). No PUPs with non-null F8 mutations developed inhibitors. CONCLUSION: In the NuProtect study, the rate of inhibitor development in PUPs with severe haemophilia A treated with simoctocog alfa was lower than the rate reported for hamster-cell-derived recombinant factor VIII products in other recent clinical trials. No inhibitors were reported in PUPs with non-null F8 mutations.

Systematic comparison of the structure of homoleptic tetradentate N2O2-type Schiff base complexes of tetravalent f-elements (M(IV) = Ce, Th, U, Np, and Pu) in solid state and in solution.

A series of tetradentate N2O2-type Schiff base complexes with tetravalent 4f- and 5f-block metals, [M(salpn)2] (H2salpn = N,N'-disalicylidene-1,3-diaminopropane; M = Ce, Th, U, Np, and Pu), were prepared to systematically investigate their solid state structure, and their complexation behaviour in solution with the goal to investigate the subtle differences between 4f- and 5f-elements. X-ray diffraction revealed that all investigated metal cations form [M(salpn)2] complexes. All the complexes show the same ligand arrangement with meridional conformation, amongst which only Ce(iv) exhibits unique behaviour upon crystallisation. [Ce(salpn)2] crystallises in two less symmetric systems (P1[combining macron] or P21/n), whilst all the other [M(salpn)2] crystallise in a more symmetric orthorhombic system (Pban). Quantum chemical calculations suggest that the observed structural peculiarity of Ce(iv) stems from the geometrical flexibility due to the more "ionic" nature of bonds to the 4f element. 1H NMR measurements revealed that [M(salpn)2] forms two different species in solution with and without an additional solvent molecule, where the relative distribution of the two species depends mainly on the ionic radius of the metal centre. Again, Ce(iv) behaves differently from the tetravalent actinides with a higher ratio of the solvent-molecule-coordinated species than the ratio expected from its ionic radius. Hence, this study is successful in observing subtle differences between 4f- (i.e. Ce) and 5f-elements (actinides; Th, U, Np, and Pu) both in the solid state and in solution on an analytically distinguishable level, and in relating the observed subtle differences to their electronic structure.

Bonding Trends in Tetravalent Th-Pu Monosalen Complexes.

The synthesis of three complex series of the form [AnCl2 (salen)(Pyx)2 ] (H2 salen=N,N'-bis(salicylidene)ethylenediamine; Pyx=pyridine, 4-methylpyridine, 3,5-dimethylpyridine) with tetravalent early actinides (An=Th, U, Np, Pu) is reported with the goal to elucidate the affinity of these heavy elements for small neutral N-donor molecules. Structure determination by single-crystal XRD and characterization of bulk powders with infrared spectroscopy reveals isostructurality within each respective series and the same complex conformation in all reported structures. Although the trend of interatomic distances for An-Cl and An-N (imine nitrogen of salen or pyridyl nitrogen of Pyx) was found to reflect an ionic behavior, the trend of the An-O distances can only be described with additional covalent interactions for all elements heavier than thorium. All experimental results are supported by quantum chemical calculations, which confirm the mostly ionic character in the An-N and An-Cl bonds, as well as the highest degree of covalency of the An-O bonds. Structurally, the calculations indicate just minor electronic or steric effects of the additional Pyx substituents on the complex properties.

Tris-{hydridotris(1-pyrazolyl)borato}actinide Complexes: Synthesis, Spectroscopy, Crystal Structure, Bonding Properties and Magnetic Behaviour.

The isostructural compounds of the trivalent actinides uranium, neptunium, plutonium, americium, and curium with the hydridotris(1-pyrazolyl)borato (Tp) ligand An[η3 -HB(N2 C3 H3 )3 ]3 (AnTp3 ) have been obtained through several synthetic routes. Structural, spectroscopic (absorption, infrared, laser fluorescence) and magnetic characterisation of the compounds were performed in combination with crystal field, density functional theory (DFT) and relativistic multiconfigurational calculations. The covalent bonding interactions were analysed in terms of the natural bond orbital (NBO) and quantum theory of atoms in molecules (QTAIM) models.

Insights into the Structural Chemistry of Anhydrous and Hydrous Hexavalent Uranium and Neptunium Dinitrato, Trinitrato, and Tetranitrato Complexes.

A systematic investigation is presented which examines the structural chemistry of anhydrous and hydrous ternary hexavalent uranium and neptunium dinitrato, trinitrato, and tetranitrato complexes. Using slow evaporation methods under acidic conditions the uranium and neptunium nitrate complexes γ-K[UO2(NO3)3], K2[UO2-cis-(NO3)4], [NpO2(NO3)2(H2O)2]·4H2O, and Cs[NpO2(NO3)3] have been synthesized and their structures refined using single-crystal X-ray diffraction data. γ-K[UO2(NO3)3] adopts an orthorhombic structure in space group Pbca consisting of antiparallel aligned [UO2(NO3)3]- moieties. K2[UO2-cis-(NO3)4] adopts a monoclinic structure in space group P21/c consisting of [UO2(NO3)4]2- moieties with two monodentate and two bidentate nitrate ligands that are arranged in a cis configuration about the uranyl, UO22+, center. Previous investigations have only identified trans variants of this monoclinic structure, and this is the first report of the cis form and also the occurrence of geometric isomerism in uranyl nitrates. [NpO2(NO3)2(H2O)2]·4H2O adopts an orthorhombic structure in space group Cmc21 consisting of parallel aligned [NpO2(NO3)2(H2O)2] moieties that are in a trans configuration with respect to the bidentate nitrate ligands. Cs[NpO2(NO3)3] adopts a hexagonal structure in space group R3c consisting of parallel aligned [NpO2(NO3)3]- moieties. It was found that despite using a Np(V) nitrate solution as the starting reagent, Np(VI) nitrate structures were consistently recovered under acidic conditions. These observations are discussed and rationalized with respect to standard reduction potentials, particularly how redox conditions and acidity affect the oxidation state of Np and subsequent structure formation. The structures uncovered in this investigation are discussed comparatively and systematically in detail with other reported anhydrous and hydrous ternary hexavalent uranium and neptunium dinitrato, trinitrato, and tetranitrato complexes, particularly with respect to how synthesis conditions, including pH and geometric isomerism, affect the structural chemistry.

Size Dependence of Lattice Parameter and Electronic Structure in CeO2 Nanoparticles.

Intrinsic properties of a compound (e.g., electronic structure, crystallographic structure, optical and magnetic properties) define notably its chemical and physical behavior. In the case of nanomaterials, these fundamental properties depend on the occurrence of quantum mechanical size effects and on the considerable increase of the surface to bulk ratio. Here, we explore the size dependence of both crystal and electronic properties of CeO2 nanoparticles (NPs) with different sizes by state-of-the art spectroscopic techniques. X-ray diffraction, X-ray photoelectron spectroscopy, and high-energy resolution fluorescence-detection hard X-ray absorption near-edge structure (HERFD-XANES) spectroscopy demonstrate that the as-synthesized NPs crystallize in the fluorite structure and they are predominantly composed of CeIV ions. The strong dependence of the lattice parameter with the NPs size was attributed to the presence of adsorbed species at the NPs surface thanks to Fourier transform infrared spectroscopy and thermogravimetric analysis measurements. In addition, the size dependence of the t2g states in the Ce LIII XANES spectra was experimentally observed by HERFD-XANES and confirmed by theoretical calculations.

A Novel Metastable Pentavalent Plutonium Solid Phase on the Pathway from Aqueous Plutonium(VI) to PuO2 Nanoparticles.

Here we provide evidence that the formation of PuO2 nanoparticles from oxidized PuVI under alkaline conditions proceeds through the formation of an intermediate PuV solid phase, similar to NH4 PuO2 CO3 , which is stable over a period of several months. For the first time, state-of-the-art experiments at Pu M4 and at L3 absorption edges combined with theoretical calculations unambiguously allow to determine the oxidation state and the local structure of this intermediate phase.

Efficacy and safety of simoctocog alfa (Nuwiq®) in patients with severe hemophilia A: a review of clinical trial data from the GENA program.

Simoctocog alfa (human-cl rhFVIII, Nuwiq®) is a 4th generation recombinant FVIII (rFVIII), without chemical modification or fusion with any other protein/fragment. Nuwiq® is produced in a human embryonic kidney cell line (HEK293F), which ensures human-specific post-translational protein processing. Nuwiq® was evaluated in seven prospective clinical studies in 201 adult and pediatric previously treated patients (PTPs) with severe hemophilia A. The NuProtect study in 110 previously untreated patients (PUPs) is ongoing. The mean half-life of Nuwiq® was 15.1-17.1 h in PTP studies with adults and adolescents, and 12.5 h in children aged 2-12 years. Clinical trials in PTPs demonstrated the efficacy and safety of Nuwiq® in the prevention and treatment of bleeds and as surgical prophylaxis. In the NuPreviq study of pharmacokinetic (PK)-guided personalized prophylaxis in 66 adult PTPs, 83% of patients had no spontaneous bleeds during 6 months of personalized prophylaxis and 57% were treated ⩽2 per week. No FVIII inhibitors were detected in PTPs after treatment with 43,267 injections and >80 million IU of Nuwiq®. Interim data for 66 PUPs with ⩾20 exposure days to Nuwiq® in NuProtect demonstrated a low cumulative high-titer inhibitor rate of 12.8% [actual incidence 12.1% (8/66)] and convincing efficacy and safety.