Factor VIII safety: plasma-derived versus recombinant products.

Abstract

It is impossible to understand the importance of safety issues regarding the use of plasma-derived and recombinant clotting factor concentrates without looking back at the evolution of the management of haemophilia over the last 50 years. The treatment of people with haemophilia improved radically following the discovery by Judith Pool in the first half of the 1960s of the possibility of concentrating anti-haemophilic factors by cryoprecipitation of plasma1,2. Various techniques for further concentrating and purifying the coagulation factors were introduced such that these factors became increasingly available and easier to infuse3. This opened up a whole new world in which people with haemophilia could treat themselves more rapidly thus limiting bleeding into their joints, could treat themselves at home thus decreasing their dependence on the emergency room, could treat themselves prophylactically prior to activities that might cause bleeding, and could travel. This progress in the management of haemophilia has dramatically improved not only the life-expectancy of these patients but also their quality of life.