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[血友病治疗的新进展]

[NEW INNOVATIONS IN THE TREATMENT OF HEMOPHILIA].

作者信息

Levy-Mendelovich Sarina, Brutman-Barazani Tami, Kenet Gili

机构信息

National Hemophilia Center, Coagulation Unit and Amalia Biron Research Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Israel.

出版信息

Harefuah. 2023 Jan;162(1):47-51.

Abstract

Hemophilia is a congenital bleeding disorder with a deficiency of coagulation factor 8 or 9 (hemophilia A or B, respectively) and a tendency for recurrent bleeding, especially into muscles and joints, which may cause orthopedic damage and necessitate joint replacement surgeries at a young age. In recent years, there has been a huge breakthrough in the treatment of hemophilia. Until recently, the only available therapy was based on repeated intravenous injection of factor concentrates (replacement therapy). Nowadays, new therapeutic options are being developed, some already registered and approved and others are still in clinical studies. The new molecules either enhance the coagulation system or inhibit coagulation inhibitors, promoting faster and improved clot formation, and are administered subcutaneously. These developments have had an enormous impact on the patients' quality of life. In the last decade, the option of complete (genetic) cure of the disease has been explored for both hemophilia A and hemophilia B, and multiple clinical gene therapy trials are currently being conducted. In this review, we discuss the novel therapies currently available for hemophilia. We will elaborate on extended half-life long acting factor concentrates, subcutaneous non-replacement therapies and gene therapy.

摘要

血友病是一种先天性出血性疾病,分别缺乏凝血因子8或9(分别为血友病A或B),并有反复出血的倾向,尤其是肌肉和关节出血,这可能导致骨科损伤,并需要在年轻时进行关节置换手术。近年来,血友病的治疗取得了巨大突破。直到最近,唯一可用的治疗方法是基于反复静脉注射因子浓缩物(替代疗法)。如今,新的治疗选择正在开发中,一些已经注册并获批,其他仍在临床研究中。这些新分子要么增强凝血系统,要么抑制凝血抑制剂,促进更快、更好的血栓形成,并通过皮下给药。这些进展对患者的生活质量产生了巨大影响。在过去十年中,已经探索了对血友病A和血友病B进行完全(基因)治愈的选择,目前正在进行多项临床基因治疗试验。在这篇综述中,我们讨论了目前可用于血友病的新型疗法。我们将详细阐述延长半衰期的长效因子浓缩物、皮下非替代疗法和基因疗法。

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