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Factor VIII Product...
Factor VIII Products and Inhibitor Development in Severe Hemophilia A
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Gouw, Samantha C. (author)
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van der Bom, Johanna G. (author)
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- Ljung, Rolf (author)
- Lund University,Lunds universitet,Enheten för pediatrisk hematologi,Forskargrupper vid Lunds universitet,Paediatric Hematologic Research Group,Lund University Research Groups
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Escuriola, Carmen (author)
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Cid, Ana R. (author)
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Claeyssens-Donadel, Segolene (author)
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van Geet, Christel (author)
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Kenet, Gili (author)
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Makipernaa, Anne (author)
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Molinari, Angelo Claudio (author)
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Muntean, Wolfgang (author)
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Kobelt, Rainer (author)
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Rivard, George (author)
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Santagostino, Elena (author)
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Thomas, Angela (author)
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van den Berg, H. Marijke (author)
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(creator_code:org_t)
- 2013
- 2013
- English.
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In: New England Journal of Medicine. - 0028-4793. ; 368:3, s. 231-239
- Related links:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
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- Background For previously untreated children with severe hemophilia A, it is unclear whether the type of factor VIII product administered and switching among products are associated with the development of clinically relevant inhibitory antibodies (inhibitor development). Methods We evaluated 574 consecutive patients with severe hemophilia A (factor VIII activity, <0.01 IU per milliliter) who were born between 2000 and 2010 and collected data on all clotting-factor administration for up to 75 exposure days. The primary outcome was inhibitor development, which was defined as at least two positive inhibitor tests with decreased in vivo recovery of factor VIII levels. Results Inhibitory antibodies developed in 177 of the 574 children (cumulative incidence, 32.4%); 116 patients had a high-titer inhibitory antibody, defined as a peak titer of at least 5 Bethesda units per milliliter (cumulative incidence, 22.4%). Plasma-derived products conferred a risk of inhibitor development that was similar to the risk with recombinant products (adjusted hazard ratio as compared with recombinant products, 0.96; 95% confidence interval [CI], 0.62 to 1.49). As compared with third-generation full-length recombinant products (derived from the full-length complementary DNA sequence of human factor VIII), second-generation full-length products were associated with an increased risk of inhibitor development (adjusted hazard ratio, 1.60; 95% CI, 1.08 to 2.37). The content of von Willebrand factor in the products and switching among products were not associated with the risk of inhibitor development. Conclusions Recombinant and plasma-derived factor VIII products conferred similar risks of inhibitor development, and the content of von Willebrand factor in the products and switching among products were not associated with the risk of inhibitor development. Second-generation full-length recombinant products were associated with an increased risk, as compared with third-generation products. (Funded by Bayer Healthcare and Baxter BioScience.)
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
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Gouw, Samantha C ...
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van der Bom, Joh ...
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Ljung, Rolf
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Escuriola, Carme ...
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Cid, Ana R.
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Claeyssens-Donad ...
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show more...
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van Geet, Christ ...
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Kenet, Gili
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Makipernaa, Anne
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Molinari, Angelo ...
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Muntean, Wolfgan ...
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Kobelt, Rainer
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Rivard, George
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Santagostino, El ...
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Thomas, Angela
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van den Berg, H. ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
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New England Jour ...
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Lund University