Departments of Pediatrics, Internal Medicine, Immunology/Microbiology and Biochemistry, Section of Pediatric Hematology/Oncology, RUSH Hemophilia and Thrombophilia Center, RUSH University Medical Center, Chicago, IL, USA.
Haemophilia. 2014 Jan;20 Suppl 1:1-9. doi: 10.1111/hae.12322.
The development of inhibitors and the need for frequent venous access for FVIII injection are major challenges in current haemophilia treatment. Presently available recombinant FVIII (rFVIII) products produced in hamster cell lines are associated with inhibitor formation in up to 32% of previously untreated patients. The new human cell line-derived recombinant human FVIII (Human-cl rhFVIII) protein is the first native, unmodified truly human rFVIII product produced in a human cell line without additive animal proteins. The aim of using a human cell line for the production of rFVIII is the avoidance of non-human epitopes on rFVIII, thereby potentially reducing the rate of inhibitor development, avoiding allergic reactions and allowing personalized prophylaxis with the chance of fewer infusions. Studies to date show that prophylaxis with Human-cl rhFVIII prevents 96% of bleeding events in adults with severe haemophilia A when compared to on-demand treatment. Available pharmacokinetic data with a mean half-life of 17.1 h allow personalized prophylaxis with the chance of fewer infusions. Studies in previously treated children and adults indicate that Human-cl rhFVIII is efficacious and safe in the prevention and treatment of bleeding episodes and that none of the treated patients developed inhibitors or allergic reactions thus far.
抑制剂的发展以及频繁的静脉通路需求是当前血友病治疗的主要挑战。目前,仓鼠细胞系生产的重组 FVIII(rFVIII)产品在多达 32%的既往未治疗患者中会引起抑制剂的形成。新型的人细胞系衍生的重组人 FVIII(Human-cl rhFVIII)蛋白是首个天然的、未经修饰的真正的人 rFVIII 产品,在人细胞系中生产,不含添加剂的动物蛋白。使用人细胞系生产 rFVIII 的目的是避免 rFVIII 上的非人类表位,从而潜在地降低抑制剂的发展速度,避免过敏反应,并允许进行个体化预防治疗,减少输注次数。迄今为止的研究表明,与按需治疗相比,Human-cl rhFVIII 预防性治疗可预防 96%的重度 A 型血友病成人出血事件。现有的药代动力学数据显示,平均半衰期为 17.1 小时,可进行个体化预防治疗,减少输注次数。既往治疗的儿童和成人研究表明,Human-cl rhFVIII 在预防和治疗出血事件方面是有效且安全的,迄今为止,没有接受治疗的患者产生抑制剂或过敏反应。