Faculty Collaboration Database

In non-severe hemophilia A the risk of inhibitor after intensive factor treatment is greater in older patients: a case-control study. J Thromb Haemost 2010 Oct;8(10):2224-31

Date

08/14/2010

Pubmed ID

20704648

Pubmed Central ID

PMC3612936

DOI

10.1111/j.1538-7836.2010.04013.x

Scopus ID

2-s2.0-78649367398 (requires institutional sign-in at Scopus site)   55 Citations

Abstract

BACKGROUND:  Twenty-five percent of new anti-factor VIII (FVIII) antibodies (inhibitors) that complicate hemophilia A occur in those with mild and moderate disease. Although intensive FVIII treatment has long been considered a risk factor for inhibitor development in those with non-severe disease, its strength of association and the influence of other factors have remained undefined.

OBJECTIVE:  To evaluate risk factors for inhibitor development in patients with non-severe hemophilia A.

METHODS:  Information on clinical and demographic variables and FVIII genotype was collected on 36 subjects with mild or moderate hemophilia A and an inhibitor and 62 controls also with mild or moderate hemophilia A but without an inhibitor.

RESULTS:  Treatment with FVIII for six or more consecutive days during the prior year was more strongly associated with inhibitor development in those ≥30years of age compared with those <30years of age [adjusted odds ratio (OR) 12.62; 95% confidence interval (CI), 2.76-57.81 vs. OR 2.54; 95% CI, 0.61-10.68]. Having previously received <50days of FVIII was also not statistically associated with inhibitor development on univariate or multivariate analysis.

CONCLUSIONS:  These findings suggest that inhibitor development in mild and moderate hemophilia A varies with age, but does not vary significantly with lifetime FVIII exposure days: two features distinct from severe hemophilia A.

Author List

Kempton CL, Soucie JM, Miller CH, Hooper C, Escobar MA, Cohen AJ, Key NS, Thompson AR, Abshire TC

MESH terms used to index this publication - Major topics in bold

Adult
Age Factors
Aged
Case-Control Studies
Factor VIII
Genotype
Hemophilia A
Humans
Male
Middle Aged
Multivariate Analysis
Mutation, Missense
Risk Factors