Wu Junzheng, Liu Xiaoling, Yang Huichuan, He Yanlin, Yu Ding
Chengdu Rongsheng Pharmaceuticals Co., Ltd, Chengdu 610041, China.
China National Biotec Group Company Limited, Beijing 100029, China.
iScience. 2024 Dec 3;27(12):111436. doi: 10.1016/j.isci.2024.111436. eCollection 2024 Dec 20.
Hemophilia is caused by the deficiency of clotting factors due to a single genetic abnormality. Replacement therapies have evolved from plasma-derived to recombinant coagulation factor concentrates but continue to have certain limitations. Monoclonal antibodies are clinical prophylactic treatment options unaffected by inhibitors and have better compliance than coagulation factor concentrates for patients with hemophilia. Gene therapy is a breakthrough in hemophilia treatment, as it drives the hepatic expression of factor VIII or factor IX and requires only a single administration to enable long-term replacement treatment in adult patients. Furthermore, biopharmaceutical products that target new pathways unaffected by inhibitors, including tissue factor pathway inhibitors, activated protein C, and antithrombin, as well as pharmaceutical technology advances to reduce dosing frequency, have demonstrated promising clinical results. This review provides a comprehensive overview of these biopharmaceutical products and explores the future of hemophilia treatment.
血友病是由单一基因异常导致凝血因子缺乏引起的。替代疗法已从血浆源性发展到重组凝血因子浓缩物,但仍有一定局限性。单克隆抗体是不受抑制剂影响的临床预防性治疗选择,对于血友病患者,其依从性优于凝血因子浓缩物。基因疗法是血友病治疗的一项突破,因为它能驱动肝脏表达凝血因子VIII或凝血因子IX,成年患者只需单次给药就能实现长期替代治疗。此外,靶向不受抑制剂影响的新途径的生物制药产品,包括组织因子途径抑制剂、活化蛋白C和抗凝血酶,以及降低给药频率的制药技术进步,都已展现出令人鼓舞的临床效果。本文综述对这些生物制药产品进行了全面概述,并探讨了血友病治疗的未来发展。