Recent cohort studies showed differences in inhibitor incidence in previously untreated patients (PUPs) with haemophilia A treated with recombinant factor VIII (rFVIII) concentrates. We carried out a systematic literature search and meta-Analysis for all randomized clinical trials and observational studies published from 1 January 1988 to 31 August 2015, to assess the incidence of inhibitor development and the relationship with rFVIII product used in PUPs and minimally treated patients (MTPs, ≤5 previous exposure days), with severe haemophilia. The primary outcome measure was development of all inhibitors and high-Titre inhibitors. We computed pooled meta-Analytic estimates according to the rFVIII product used with the inverse-variance method, assuming a fixed, or a random-effects model if significant between-studies heterogeneity was present. Out of 781 articles, 16 published between 1998 and 2015 were included in the meta-Analysis, involving a total of 2094 haemophilia A PUPs or MTPs. The pooled estimate of all inhibitors was 0.27 (95% confidence interval 0.23-0.31). No significant difference in pooled inhibitor incidence across products was found (P = 0.72). Meta-Analysis of studies reporting inhibitor hazard ratios with different rFVIII products, adjusted to different risk factors, showed that PUPs/MTPs treated with Advate had a pooled inhibitor hazard ratio estimate of 0.63 (95% confidence interval 0.48-0.83) as compared with Kogenate FS. The overall inhibitor incidence in PUPs/MTPs was 27%. Differences between products were found considering hazard ratios in which potential confounders were taken into account.

Rota, M., Cortesi, P., Steinitz Trost, K., Reininger, A., Gringeri, A., Mantovani, L. (2017). Meta-analysis on incidence of inhibitors in patients with haemophilia A treated with recombinant factor VIII products. BLOOD COAGULATION & FIBRINOLYSIS, 28(8), 627-637 [10.1097/MBC.0000000000000647].

Meta-analysis on incidence of inhibitors in patients with haemophilia A treated with recombinant factor VIII products

Rota, M;Cortesi, PA
;
Mantovani, LG
2017

Abstract

Recent cohort studies showed differences in inhibitor incidence in previously untreated patients (PUPs) with haemophilia A treated with recombinant factor VIII (rFVIII) concentrates. We carried out a systematic literature search and meta-Analysis for all randomized clinical trials and observational studies published from 1 January 1988 to 31 August 2015, to assess the incidence of inhibitor development and the relationship with rFVIII product used in PUPs and minimally treated patients (MTPs, ≤5 previous exposure days), with severe haemophilia. The primary outcome measure was development of all inhibitors and high-Titre inhibitors. We computed pooled meta-Analytic estimates according to the rFVIII product used with the inverse-variance method, assuming a fixed, or a random-effects model if significant between-studies heterogeneity was present. Out of 781 articles, 16 published between 1998 and 2015 were included in the meta-Analysis, involving a total of 2094 haemophilia A PUPs or MTPs. The pooled estimate of all inhibitors was 0.27 (95% confidence interval 0.23-0.31). No significant difference in pooled inhibitor incidence across products was found (P = 0.72). Meta-Analysis of studies reporting inhibitor hazard ratios with different rFVIII products, adjusted to different risk factors, showed that PUPs/MTPs treated with Advate had a pooled inhibitor hazard ratio estimate of 0.63 (95% confidence interval 0.48-0.83) as compared with Kogenate FS. The overall inhibitor incidence in PUPs/MTPs was 27%. Differences between products were found considering hazard ratios in which potential confounders were taken into account.
Articolo in rivista - Articolo scientifico
antibodies; factor VIII inhibitors; meta-analysis; minimally treated patients; previously untreated patients; severe haemophilia A
English
3-lug-2017
2017
28
8
627
637
none
Rota, M., Cortesi, P., Steinitz Trost, K., Reininger, A., Gringeri, A., Mantovani, L. (2017). Meta-analysis on incidence of inhibitors in patients with haemophilia A treated with recombinant factor VIII products. BLOOD COAGULATION & FIBRINOLYSIS, 28(8), 627-637 [10.1097/MBC.0000000000000647].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/159637
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