Haemophilia: factoring in new therapies

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.

Keywords: factor IX; factor VIII; gene therapy; haemophilia; haemophilia B.

Publication types

  • Review

MeSH terms

  • Animals
  • Disease Management
  • Factor IX / therapeutic use
  • Factor VIII / therapeutic use
  • Genetic Therapy / methods
  • Hemophilia A / genetics
  • Hemophilia A / therapy*
  • Hemophilia B / genetics
  • Hemophilia B / therapy*
  • Hemorrhage / genetics
  • Hemorrhage / therapy
  • Humans

Substances

  • F8 protein, human
  • Factor VIII
  • Factor IX