How to choose the coagulation factor concentrate for the treatment of child with haemophilia?

Abstract

The introduction of the coagulation factor VIII and IX concentrates has changed the treatment of haemophilia patients dramatically. The concentrates were produced from pooled human plasma in the beginning. During the 1990s of the 20th century, recombinant factor VIII was accessed, then factor IX was introduced. The modern methods of elimination and inactivation of viruses led to the development of safe plasma-derived products. However, minimal risk of viral transmission is still greater by plasma-derived than recombinant concentrates. The efficacy of both products is very good in treatment of bleeds as well as in surgery and prophylaxis. The pharmacokinetics of plasma-derived and recombinant factor VIII is similar. Nevertheless, the recovery of recombinant factor IX is lower than plasma-derived, therefore the doses of recombinant factor IX should be 30% higher. The half-life of both factor IX products is almost the same. In developed countries recombinant coagulation factor concentrates are recommended treatment of choice for patients with haemophilia and almost all children are being treated with them.