<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction</bold>. Our research strategy was aimed at evaluating the possible implication of the type of factor VIII product administered as substitution treatment to haemophilia A patients in the occurrence of inhibitors and their consequences on the management.<bold>Methods</bold>. Scientific articles from July 2015 to July 2017 were searched using the PubMed and PubMed Central databases. The used search terms included “haemophilia A”, “inhibitors”, “plasma-derived factor VIII” and “recombinant factor VIII”.<bold>Results</bold>. The risk factors for inhibitors occurrence may be patients-related (genetic and nongenetic) and treatment-related. The possibility of a correlation between the increased purity of factor VIII given as substitution treatment and the occurrence of inhibitors is discussed in the light of literature data. Plasma-derived factor VIII is less immunogenic, but not entirely safe from the point of view of the possibility of transmitting biological agents. It is obvious that there is not enough plasma-derived factor VIII for the planet’s needs. Recombinant factor VIII products have revolutionized the treatment of patients with haemophilia A over the past 3 decades by the disappearance of transfusion-related infections and their complications. They are safer in terms of pathogens and the new long-acting factor VIII products are based on recombinant DNA technology.<bold>Conclusion</bold>. Plasma-derived or recombinant factor VIII products must co-exist on the market for the benefit of haemophilic patients. Future solutions could be: less immunogenic factor VIII products, nonfactor replacement strategies, or bispecific antibody that mimics the function of coagulation factor VIII.</abstract>

Introduction. Our research strategy was aimed at evaluating the possible implication of the type of factor VIII product administered as substitution treatment to haemophilia A patients in the occurrence of inhibitors and their consequences on the management.Methods. Scientific articles from July 2015 to July 2017 were searched using the PubMed and PubMed Central databases. The used search terms included “haemophilia A”, “inhibitors”, “plasma-derived factor VIII” and “recombinant factor VIII”.Results. The risk factors for inhibitors occurrence may be patients-related (genetic and nongenetic) and treatment-related. The possibility of a correlation between the increased purity of factor VIII given as substitution treatment and the occurrence of inhibitors is discussed in the light of literature data. Plasma-derived factor VIII is less immunogenic, but not entirely safe from the point of view of the possibility of transmitting biological agents. It is obvious that there is not enough plasma-derived factor VIII for the planet’s needs. Recombinant factor VIII products have revolutionized the treatment of patients with haemophilia A over the past 3 decades by the disappearance of transfusion-related infections and their complications. They are safer in terms of pathogens and the new long-acting factor VIII products are based on recombinant DNA technology.Conclusion. Plasma-derived or recombinant factor VIII products must co-exist on the market for the benefit of haemophilic patients. Future solutions could be: less immunogenic factor VIII products, nonfactor replacement strategies, or bispecific antibody that mimics the function of coagulation factor VIII.

The inhibitors – a challenge for the management of patients with hereditary haemophilia A

Department of Hematology, Emergency County Clinical Hospital Sibiu

Romanian Journal of Internal Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Introduction. Our research strategy was aimed at evaluating the possible implication of the type of factor VIII product administered as substitution treatment...

The inhibitors – a challenge for the management of patients with hereditary haemophilia A

Published Online: Aug 29, 2018

Page range: 143 - 152

Received: Mar 03, 2018

DOI: https://doi.org/10.2478/rjim-2018-0013

Keywords
Haemophilia A, Inhibitors, Neutralizing alloantibodies, Plasma-derived factor VIII, Recombinant factor VIII

© 2018 Romeo-Gabriel Mihăilă, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

The inhibitors – a challenge for the management of patients with hereditary haemophilia A

Published Online: Aug 29, 2018

Page range: 143 - 152

Received: Mar 03, 2018

DOI: https://doi.org/10.2478/rjim-2018-0013

KeywordsHaemophilia A, Inhibitors, Neutralizing alloantibodies, Plasma-derived factor VIII, Recombinant factor VIII

© 2018 Romeo-Gabriel Mihăilă, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
Haemophilia A, Inhibitors, Neutralizing alloantibodies, Plasma-derived factor VIII, Recombinant factor VIII