Division of Hematology/Oncology, Maimonides Medical Center, Brooklyn, NY, USA.
University of Illinois College of Medicine, and the Bleeding and Clotting Disorders Institute, Peoria, IL, USA.
Expert Rev Hematol. 2023 Jun;16(6):417-433. doi: 10.1080/17474086.2023.2184341. Epub 2023 Mar 8.
The past few decades have seen a tremendous advancement in the management of hemophilia. Whether it is improved methods to attenuate critical viruses, recombinant bioengineering with decreased immunogenicity, extended half-life replacement therapies to mitigate the burden of repeated infusion treatments, novel nonreplacement products to avoid the drawback of inhibitor development with its attractive subcutaneous administration and then the introduction of gene therapy, the management has trodden a long way.
This expert review describes the progress in the treatment of hemophilia over the years. We discuss, in detail, the past and current therapies, their benefits, drawbacks, along with relevant studies leading to approval, efficacy and safety profile, ongoing trials, and future prospects.
The technological advances in the treatment of hemophilia with convenient modes of administration and innovative modalities offer a chance for a normal existence of the patients living with this disease. However, it is imperative for clinicians to be aware of the potential adverse effects and the need for further studies to establish causality or chance association of these events with novel agents. Thus, it is crucial for clinicians to engage patients and their families in informed decision-making and tailor individual concerns and necessities.
过去几十年,血友病的治疗取得了巨大进展。无论是改进的减毒关键病毒方法、降低免疫原性的重组生物工程、延长半衰期的替代疗法以减轻反复输注治疗的负担、避免抑制剂发展及其具有吸引力的皮下给药的新型非替代产品,还是基因治疗的引入,治疗方法都取得了长足的进步。
本专家综述描述了多年来血友病治疗方面的进展。我们详细讨论了过去和当前的治疗方法、它们的益处、缺点,以及相关的研究,包括批准、疗效和安全性概况、正在进行的试验和未来前景。
治疗血友病的技术进步,具有方便的给药方式和创新模式,为患有这种疾病的患者提供了正常生活的机会。然而,临床医生必须意识到潜在的不良反应,并需要进一步的研究来确定这些事件与新型药物之间的因果关系或偶然关联。因此,临床医生必须让患者及其家属参与知情决策,并根据个人的关注和需求进行调整。