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Switching treatments in haemophilia: is there a risk of inhibitor development?

Santagostino, Elena; Auerswald, Guenter; Benson, Gary; Dolan, Gerry; Jimenez-Yuste, Victor; Lambert, Thierry; Ljung, Rolf LU ; Morfini, Massimo; Remor, Eduardo and Salek, Silva Zupancic (2015) In European Journal of Haematology 94(4). p.284-289
Abstract
Patients with haemophilia A (and their physicians) may be reluctant to switch factor VIII (FVIII) concentrates, often due to concerns about increasing the risk of inhibitors; this reluctance to switch may contribute to patients missing the clinical benefits provided by the arrival of new factor VIII products. This topic was explored at the Eleventh Zurich Haemophilia Forum. Clinical scenarios for which product switching may be cause for concern were discussed; when there is a clinical need, there are no absolute contraindications to switching, but some patients (e.g. previously untreated patients and those undergoing elective surgery) may require more careful consideration. Both patient and physician surveys indicate that the reluctance to... (More)
Patients with haemophilia A (and their physicians) may be reluctant to switch factor VIII (FVIII) concentrates, often due to concerns about increasing the risk of inhibitors; this reluctance to switch may contribute to patients missing the clinical benefits provided by the arrival of new factor VIII products. This topic was explored at the Eleventh Zurich Haemophilia Forum. Clinical scenarios for which product switching may be cause for concern were discussed; when there is a clinical need, there are no absolute contraindications to switching, but some patients (e.g. previously untreated patients and those undergoing elective surgery) may require more careful consideration. Both patient and physician surveys indicate that the reluctance to switch, and the fear of inhibitor development, does not appear to be evidence based. The evaluation of more recent data did not support previous studies suggesting that particular products (e.g. recombinant vs. plasma-derived and full length vs. B-domain modified) may be associated with increased risk. In addition, data from three national product switches showed that switching was not associated with increased inhibitor risk, but highlighted the need for regular inhibitor testing and for a centralised, unbiased database of inhibitor incidence. To conclude, current evidence does not suggest that switching products significantly influences inhibitor development. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
haemophilia, inhibitors, product switching
in
European Journal of Haematology
volume
94
issue
4
pages
284 - 289
publisher
Wiley-Blackwell
external identifiers
  • wos:000351628000002
  • scopus:84925411090
ISSN
1600-0609
DOI
10.1111/ejh.12433
language
English
LU publication?
yes
id
02f86d94-a9b3-41d8-ad9f-255125940f9a (old id 5281890)
date added to LUP
2015-05-04 08:54:29
date last changed
2017-05-21 03:10:25
@article{02f86d94-a9b3-41d8-ad9f-255125940f9a,
  abstract     = {Patients with haemophilia A (and their physicians) may be reluctant to switch factor VIII (FVIII) concentrates, often due to concerns about increasing the risk of inhibitors; this reluctance to switch may contribute to patients missing the clinical benefits provided by the arrival of new factor VIII products. This topic was explored at the Eleventh Zurich Haemophilia Forum. Clinical scenarios for which product switching may be cause for concern were discussed; when there is a clinical need, there are no absolute contraindications to switching, but some patients (e.g. previously untreated patients and those undergoing elective surgery) may require more careful consideration. Both patient and physician surveys indicate that the reluctance to switch, and the fear of inhibitor development, does not appear to be evidence based. The evaluation of more recent data did not support previous studies suggesting that particular products (e.g. recombinant vs. plasma-derived and full length vs. B-domain modified) may be associated with increased risk. In addition, data from three national product switches showed that switching was not associated with increased inhibitor risk, but highlighted the need for regular inhibitor testing and for a centralised, unbiased database of inhibitor incidence. To conclude, current evidence does not suggest that switching products significantly influences inhibitor development.},
  author       = {Santagostino, Elena and Auerswald, Guenter and Benson, Gary and Dolan, Gerry and Jimenez-Yuste, Victor and Lambert, Thierry and Ljung, Rolf and Morfini, Massimo and Remor, Eduardo and Salek, Silva Zupancic},
  issn         = {1600-0609},
  keyword      = {haemophilia,inhibitors,product switching},
  language     = {eng},
  number       = {4},
  pages        = {284--289},
  publisher    = {Wiley-Blackwell},
  series       = {European Journal of Haematology},
  title        = {Switching treatments in haemophilia: is there a risk of inhibitor development?},
  url          = {http://dx.doi.org/10.1111/ejh.12433},
  volume       = {94},
  year         = {2015},
}