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Role of enhanced half‐life factor VIII and IX in the treatment of haemophilia
Author(s) -
Mahdi Ali J.,
Obaji Samya G.,
Collins Peter W.
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13360
Subject(s) - haemophilia , medicine , haemophilia b , factor ix , haemophilia a , regimen , arthropathy , clinical trial , intensive care medicine , immunology , surgery , pathology , alternative medicine , osteoarthritis
Summary Treatment of congenital haemophilia with factor VIII and IX concentrates often requires frequent infusions. This has obvious implications in establishing effective administration strategies and, in turn, adherence. To overcome these issues, three main technologies – polyethylene‐glycol, Fc‐neonatal IgG 1 and albumin fusion products – have emerged into various stages of clinical development. Published data indicates an approximately 1·5‐ and fivefold increase in half‐life of factor VIII and IX , respectively, compared to standard recombinant concentrates. Studies into efficacy and safety are starting to be published. Monitoring and optimal use of these new concentrates remains unknown. Weekly factor IX prophylaxis appears to be a feasible prophylactic regimen in haemophilia B patients. Weekly longer‐acting FVIII is unlikely to provide adequate prophylaxis in most patients with haemophilia A but may reduce the frequency of infusions. Ongoing clinical trials and real life experience will help shape how these products can be used in practice and their cost effectiveness. The drive for convenience however should not overshadow the ultimate goal of prophylaxis, namely, preventing bleeding and arthropathy.