The role of emicizumab, a bispecific factor IXa- and factor X-directed antibody, for the prevention of bleeding episodes in patients with hemophilia A

被引:29
|
作者
Knight, Tristan [1 ]
Callaghan, Michael U. [1 ]
机构
[1] Childrens Hosp Michigan, Div Pediat Hematol Oncol, Carmen & Ann Adams Dept Pediat, 3901 Beuabien St, Detroit, MI 48201 USA
关键词
ACE910 (M000618665); antibodies; bispecific (D12.776.124.486.485.114.125); emicizumab (C000608208); factor VIII (D12.776.124.125.350); hemophilia A (C15.378.100.100.500); IMMUNE TOLERANCE INDUCTION; FACTOR-VIII INHIBITORS; ANTIHEMOPHILIC-FACTOR; PROPHYLAXIS; MANAGEMENT; COAGULATION; ACE910; MODEL; PHARMACOKINETICS; GUIDELINES;
D O I
10.1177/2040620718799997
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Hemophilia A, characterized by impaired or absent expression of factor VIII, has long been managed via direct factor replacement. Functionally, factor VIII acts as a cofactor for factor IXa and allows activation of factor X, which, in combination with factor V, generates thrombin. Bispecific antibodies such as emicizumab are recombinant, monoclonal antibodies capable of recognizing and binding to two distinct antigenic targets simultaneously; emicizumab binds factors IXa and X, resulting in spatial approximation and activation of factor X, thereby mimicking the actions of factor VIII. Critically, the presence of antifactor VIII antibodies, for example, inhibitors, impacts neither the mechanism nor the efficacy by which emicizumab functions. The results and interim analyses of the emicizumab clinical trials, HAVEN 1, 2, 3, and 4, are additionally reviewed and discussed.
引用
收藏
页码:319 / 334
页数:16
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