title: The case for wider use of recombinant factor VIII concentrates.
abstract: The introduction of clotting factor concentrates led to major advances in hemophilia care. Rather than simply providing an alternative to plasma-derived concentrates, the introduction in the 1990s of recombinant concentrates added value to replacement therapy particularly with respect to prophylaxis and immune-tolerance induction. While the safety of plasma-derived concentrates has improved considerably, these concentrates may still pose an infectious risk through as-yet unknown pathogens and poor impurity constituent characterization. Recombinant concentrates are increasingly used because of their benefits in pathogen safety, convenience and the potential for unfettered supply. Yet worldwide they remain accessible only to a limited number of patients due to fear of the potential for inhibitor development, overestimation of their costs and underestimation of their benefits. This article reviews the characteristics and properties of recombinant FVIII concentrates to help physicians and patient representatives promote the right of access of patients to the safest products.
authors.affiliation: Hemostasis and Thrombosis Unit, Haemophilia Clinic, CliniquesUniversitaires Saint-Luc, Catholic University of Louvain, 1200 Brussels, Belgium. cedric.hermans@uclouvain.be
authors.forename: Cedric
authors.initials: C
authors.lastname: Hermans
authors.forename: Hans-Hermann
authors.initials: HH
authors.lastname: Brackmann
authors.forename: Piercarla
authors.initials: P
authors.lastname: Schinco
authors.forename: Günter
authors.initials: G
authors.lastname: Auerswald
mesh_terms: D001781:Blood Component Removal; D002986:Clinical Trials as Topic; D003428:Cross Infection / Q000517:prevention & control / Q000635:transmission; D019468:Disease Management; D004334:Drug Administration Schedule; D004340:Drug Contamination / Q000517:prevention & control; D005169:Factor VIII / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006467:Hemophilia A / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D010949:Plasma / Q000737:chemistry; D017410:Practice Guidelines as Topic; D014777:Virus Diseases / Q000517:prevention & control / Q000635:transmission
chemical_list: C427184:recombinant factor VIII SQ; D005169:Factor VIII