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PLASMA‐DERIVED VERSUS RECOMBINANT FACTOR VIII FOR THE TREATMENT OF HEMOPHILIA A
Author(s) -
KASPER CAROL K.
Publication year - 1996
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/j.1423-0410.1996.tb01361.x
Subject(s) - economic shortage , recombinant dna , risk factor , medicine , intensive care medicine , chemistry , biochemistry , linguistics , philosophy , government (linguistics) , gene
Many excellent concentrates now exist for treating hemophilia A. The risk of transmitting donor viral infections with plasma‐derived factor VIII (pdVIII) has been reduced to a very low level; the risk of undetected microbial contamination of recombinant factor VIII (rVIII) probably is much lower, but is not zero. The risk of inducing an excess number of inhibitors (neoantigenicity) may vary among pdVIII brands and may be higher with rVIII than with the least antigenic pdVIII, but the relative risks are unproven. The lowest prices now charged in some areas for excellent pdVIII, or the additional cost in some areas of preparing pdVIII from local blood or plasma donations, are lower than the lowest price charged now or predicted for the future for rVIII. Shortages of both pdVIII and rVIII have occurred. Although pdVIII may remain the mainstay of those countries with limited budgets, and those that want to preserve self‐sufficiency, while rVIII may be preferred by those who can afford its perceived lower risk of infection, multiple options should be kept open.