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Blood, 1 January 2006, Vol. 107, No. 1, pp. 46-51. Prepublished online as a Blood First Edition Paper on September 15, 2005; DOI 10.1182/blood-2005-04-1371. This Article Full Text (PDF) All Versions of this Article: 2005-04-1371v1 107/1/46    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Goudemand, J. Articles by Calvez, T. Search for Related Content PubMed PubMed Citation Articles by Goudemand, J. Articles by Calvez, T. Related Collections Related Article in Blood Online Related Letter in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted April 4, 2005 Accepted August 2, 2005 Influence of the type of factor VIII concentrate on the incidence of factor VIII inhibitors in previously untreated patients with severe hemophilia A Jenny Goudemand*, Chantal Rothschild, Virginie Demiguel, Christine Vinciguerra, Thierry Lambert, Herve Chambost, Annie Borel-Derlon, Segolene Claeyssens, Yves Laurian, and Thierry Calvez Hemophilia Treatment Centers of University of Lille, University of Lille, Lille, France Hemophilia Treatment Center, Paris AP-HP Necker, Paris, France INSERM U 720, Paris, France Haematology Department Hospital Edouard Herriot, University of Lyon, Lyon, France Hemophilia Treatment Center, Paris AP-HP Bicetre, Paris, France Hemophilia Treatment Center, University of Marseille, Marseille, France Hemophilia Treatment Center, University of Caen, Caen, France Hemophilia Treatment Center, University of Toulouse, Toulouse, France Medical University of Paris XIII, Paris, France * Corresponding author; email: j-goudemand{at}chru-lille.fr. Inhibitor development is the major treatment complication in children with severe hemophilia A. It is not clear whether the risk of inhibitors is higher with recombinant factor VIII or with plasma-derived factor VIII. We used multivariate analysis to compare two cohorts of previously untreated patients (PUPs) with severe hemophilia A: 62 patients treated with the same brand of high-purity plasma derived FVIII (pFVIII) containing von Willebrand factor (VWF), and 86 patients treated with full-length recombinant FVIII (rFVIII). In addition to the usual endpoints (all inhibitors, high inhibitors), we also examined a third endpoint (high inhibitors and/or immune tolerance induction). The risk of inhibitor development was higher in patients treated with rFVIII than in patients treated with pFVIII, regardless of other risk factors (FVIII genotype; non Caucasian origin; history of inhibitors in patients with a family history of hemophilia; age at first FVIII infusion). The adjusted relative risk (RRa) for inhibitor development with rFVIII versus pFVIII was 2.4, 2.6 and 3.2, respectively, depending on the end-point (see above). The pathophysiology of this large effect must be understood in order to improve the characteristics of recombinant products and to reduce the incidence of inhibitors to FVIII. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Factor VIII: purer is not necessarily better Edward G. D. Tuddenham Blood 2006 107: 4-5. [Full Text] [PDF] Related Letter in Blood Online: Assessing the risk of inhibitor formation with different factor VIII products Pier M. Mannucci, Jenny Goudemand, Chantal Rothschild, Yves Laurian, and Thierry Calvez Blood 2006 107: 3809-3810. [Full Text] [PDF] This article has been cited by other articles: K. R. Viel, A. Ameri, T. C. Abshire, R. V. Iyer, R. G. Watts, C. Lutcher, C. Channell, S. A. Cole, K. M. Fernstrom, S. Nakaya, et al. 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[Full Text] [PDF] J. G. van der Bom, S. C. Gouw, and H. M. van den Berg Response: Immunogenicity of factor VIII concentrates in patients with hemophilia: the next sensible step Blood, October 15, 2007; 110(8): 3085 - 3085. [Full Text] [PDF] S. Delignat, S. Dasgupta, S. Andre, A.-M. Navarrete, S. V. Kaveri, J. Bayry, M.-H. Andre, S. Chtourou, Z. Tellier, and S. Lacroix-Desmazes Comparison of the immunogenicity of different therapeutic preparations of human factor VIII in the murine model of hemophilia A Haematologica, October 1, 2007; 92(10): 1423 - 1426. [Abstract] [Full Text] [PDF] J. Redwine and R. J. Bold Perioperative Care of the Patient With Hemophilia Undergoing Urgent Appendectomy Arch Surg, September 1, 2007; 142(9): 894 - 897. [Abstract] [Full Text] [PDF] J. G. van der Bom, S. C. Gouw, and H. 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VWF protects FVIII from endocytosis by dendritic cells and subsequent presentation to immune effectors Blood, January 15, 2007; 109(2): 610 - 612. [Abstract] [Full Text] [PDF] P. M. Mannucci, J. Goudemand, C. Rothschild, Y. Laurian, and T. Calvez Assessing the risk of inhibitor formation with different factor VIII products. Blood, May 1, 2006; 107(9): 3809 - 3810. [Full Text] [PDF] D. Lillicrap The Role of Immunomodulation in the Management of Factor VIII Inhibitors Hematology, January 1, 2006; 2006(1): 421 - 425. [Abstract] [Full Text] [PDF]

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