Pediatric Hematology Oncology, Children's Hospital of Michigan, Detroit, MI, USA.
Pediatric Hematology Oncology, Emory University and Aflac Cancer and Blood Disorders, Atlanta, GA, USA.
Expert Opin Investig Drugs. 2022 Nov;31(11):1169-1186. doi: 10.1080/13543784.2022.2138742. Epub 2022 Nov 9.
Hemophilia A is a severe bleeding disorder affecting about 1 in 5,000 males. The gold standard for prophylaxis and treatment of acute bleeding has been factor (F) VIII concentrate. A multitude of treatment modalities are now available and under clinical investigation.
This review discusses ongoing/recently completed early-phase clinical trials registered on ClinicalTrials.gov in patients with hemophilia A through April 2022. These new pipeline therapies are focused on addressing the safety and efficacy of new factor-related products, non-factor related products, and gene therapy options for hemophilia.
Current standard of care effectively prevents and treats acute bleeding and has significantly improved the quality of life in hemophilia. The biggest challenges in the improvement of care are treatment-related burden and the burden of cost in developing countries. New drugs under development are likely to enter practice by the end of this decade and address many of the unmet needs particularly of those with severe disease. Data is limited in unique populations (e.g. congenital/inherited FVIII inhibitors, non-severe hemophilia A, women/girls with hemophilia and children) which are important areas for future research; additional clinical trials and long-term outcome data are necessary prior to incorporating these new therapies in our treatment arsenal.
血友病 A 是一种严重的出血性疾病,约影响每 5000 名男性中的 1 人。因子 (F) VIII 浓缩物是预防和治疗急性出血的金标准。目前有多种治疗方法正在临床研究中。
本文讨论了截至 2022 年 4 月在 ClinicalTrials.gov 上注册的血友病 A 患者的正在进行/最近完成的早期临床试验。这些新的治疗方法主要集中在解决新型因子相关产品、非因子相关产品和血友病基因治疗选择的安全性和有效性问题。
目前的标准治疗方法可有效预防和治疗急性出血,并显著提高了血友病患者的生活质量。改善治疗的最大挑战是与治疗相关的负担和发展中国家的成本负担。新开发的药物可能在本十年末投入使用,并解决许多未满足的需求,特别是那些患有严重疾病的患者。在某些特定人群(例如先天性/遗传性 FVIII 抑制剂、非重度血友病 A、女性/女孩血友病和儿童)的数据有限,这些都是未来研究的重要领域;在将这些新疗法纳入我们的治疗方案之前,需要进行更多的临床试验和长期结果数据。