EurekaMag.com logo
+ Site Statistics
References:
53,869,633
Abstracts:
29,686,251
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Recombinant versus plasma-derived factor VIII products and the development of inhibitors in previously untreated patients with severe hemophilia A: the CANAL cohort study



Recombinant versus plasma-derived factor VIII products and the development of inhibitors in previously untreated patients with severe hemophilia A: the CANAL cohort study



Blood 109(11): 4693-4697



It has been suggested that plasma-derived factor VIII products induce fewer inhibitors than recombinant factor VIII products. We investigated the relationship of factor VIII product type and switching between factor VIII products with the risk to develop inhibitors. This multicenter retrospective cohort study included 316 patients with severe hemophilia A born between 1990 and 2000. The outcome was clinically relevant inhibitor development, defined as the occurrence of at least 2 positive inhibitor titers with decreased recovery. The risk of inhibitor development was not clearly lower in plasma-derived compared with recombinant factor VIII products (relative risk [RR], 0.8; 95% confidence interval [CI], 0.5-1.3). Among high-titer inhibitors, the possible reduction in risk was even less pronounced (RR, 0.9; CI, 0.5-1.5). Plasma-derived products with considerable quantities of von Willebrand factor (VWF) carried the same risk for inhibitor development as recombinant factor VIII products (RR, 1.0; CI, 0.6-1.6). Switching between factor VIII products did not increase the risk for inhibitors (RR, 1.1; CI, 0.6-1.8). In conclusion, our findings support neither the notion that plasma-derived factor VIII products with considerable concentrations of VWF confer a lower risk to develop inhibitory antibodies than recombinant factor VIII products, nor that switching between factor VIII product brands increases inhibitor risks in previously untreated patients with severe hemophilia A.

(PDF emailed within 0-6 h: $19.90)

Accession: 013808143

Download citation: RISBibTeXText

PMID: 17218379

DOI: 10.1182/blood-2006-11-056317



Related references

Cumulative inhibitor incidence in previously untreated patients with severe hemophilia A treated with plasma-derived versus recombinant factor VIII concentrates: a critical systematic review. Critical Reviews in Oncology/Hematology 81(1): 82-93, 2012

Cost analysis of plasma-derived factor VIII/von Willebrand factor vs recombinant factor VIII for treatment of previously untreated patients with severe hemophilia A in the United States. Journal of Medical Economics: 1-16, 2018

Recombinant factor VIII for the treatment of previously untreated patients with hemophilia A. Safety, efficacy, and development of inhibitors. Kogenate Previously Untreated Patient Study Group. New England Journal of Medicine 328(7): 453-459, 1993

Recombinant factor VIII products and inhibitor development in previously untreated boys with severe hemophilia A. Blood 124(23): 3398-3408, 2015

Rates of Inhibitor development in previously untreated patients with severe hemophilia A treated with plasma-derived or recombinant factor VIII: no proof of difference or proof of no difference?. Seminars in Thrombosis and Hemostasis 40(2): 269-270, 2014

Rate of inhibitor development in previously untreated hemophilia A patients treated with plasma-derived or recombinant factor VIII concentrates: a systematic review. Journal of Thrombosis and Haemostasis 8(6): 1256-1265, 2010

High-titre inhibitors in previously untreated patients with severe haemophilia A receiving recombinant or plasma-derived factor VIII: a budget-impact analysis. Blood Transfusion 16(2): 215-220, 2017

Recombinant factor VIII for the treatment of previously untreated patients with hemophilia A: Safety, efficacy and development of inhibitors. New England Journal of Medicine 328(7): 453-459, 1993

Influence of the type of factor VIII concentrate on the incidence of factor VIII inhibitors in previously untreated patients with severe hemophilia A. Blood 107(1): 46-51, 2005

Influence of the type of factor VIII concentrate on the incidence of factor VIII inhibitors in previously untreated patients with severe hemophilia A. Blood 107(1): 46-51, 2006

Clinical studies of recombinant factor VIII in previously untreated patients with severe hemophilia A. Blood 82(10 SUPPL 1): 446A, 1993

Inhibitor development in previously untreated patients with hemophilia A: a prospective long-term follow-up comparing plasma-derived and recombinant products. Seminars in Thrombosis and Hemostasis 28(3): 285-290, 2002

Measurement of anti-factor VIII IgG, IgG4 and IgM alloantibodies in previously untreated hemophilia A patients treated with recombinant factor VIII. Kogenate Japanese Clinical Study Group. International Journal of Hematology 62(1): 35-43, 1995

Relationship between factor VIII mutation type and inhibitor development in a cohort of previously untreated patients treated with recombinant factor VIII (Recombinate). Recombinate PUP Study Group. Thrombosis and Haemostasis 83(6): 844-848, 2000

Factor VIII brand and the incidence of factor VIII inhibitors in previously untreated UK children with severe hemophilia A, 2000-2011. Blood 124(23): 3389-3397, 2015