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血友病:新疗法的考量。

Haemophilia: factoring in new therapies.

机构信息

Tufts University School of Medicine, Boston, MA, USA.

Weill Cornell Medicine, New York, NY, USA.

出版信息

Br J Haematol. 2021 Sep;194(5):835-850. doi: 10.1111/bjh.17580. Epub 2021 Jul 28.

Abstract

Haemophilia is an inherited bleeding disorder in which the haemostatic defect results from deficiency of coagulation factor VIII (FVIII) in haemophilia A or factor IX (FIX) in haemophilia B. Traditional treatments for haemophilia have largely worked by directly replacing the missing coagulation factor, but face challenges due to the short half-life of FVIII and FIX, the need for frequent intravenous access and development of neutralising antibodies to coagulation factors (inhibitors). Recent advances in haemophilia therapy have worked to eliminate these challenges. Half-life extension of factor concentrates has lengthened the time needed between infusions, enhancing quality of life. Subcutaneous administration of therapeutics utilising alternative mechanisms to overcome inhibitors have expanded the options to prevent bleeding. Finally, initial successes with gene therapy offer a cautious hope for durable cure. In the present review, we will discuss currently available treatments, as well as highlight therapeutics in various stages of clinical development for the treatment of haemophilia A and B. In this review, we present therapies that are currently clinically available and highlight therapeutics that are in various stages of clinical development for the treatment of haemophilia A and B.

摘要

血友病是一种遗传性出血性疾病,其止血缺陷是由于凝血因子 VIII(FVIII)缺乏引起的血友病 A 或凝血因子 IX(FIX)缺乏引起的血友病 B。传统的血友病治疗方法在很大程度上是通过直接替代缺失的凝血因子来实现的,但由于 FVIII 和 FIX 的半衰期短、需要频繁的静脉通路以及对凝血因子产生中和抗体(抑制剂),面临着挑战。血友病治疗的最新进展已经努力克服了这些挑战。通过延长因子浓缩物的半衰期,减少了输注之间的间隔时间,提高了生活质量。利用替代机制克服抑制剂的皮下给药疗法扩大了预防出血的选择。最后,基因治疗的初步成功为持久治愈提供了谨慎的希望。在本次综述中,我们将讨论目前可用的治疗方法,并强调处于不同临床开发阶段的治疗血友病 A 和 B 的疗法。

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