REIPERT, B. M., B. GANGADHARAN, C. J. HOFBAUER, V. BERG, H. SCHWEIGER, J. BOWEN, Jan BLATNÝ, K. FIJNVANDRAAT, E. S. MULLINS, J. KLINTMAN, C. MALE, C. MCGUINN, S. L. MEEKS, V. C. RADULESCU, M. V. RAGNI, M. RECHT, A. D. SHAPIRO, J. M. STABER, H. M. YAISH, E. SANTAGOSTINO and D. L. BROWN. The prospective Hemophilia Inhibitor PUP Study reveals distinct antibody signatures prior to FVIII inhibitor development. BLOOD ADVANCES. WASHINGTON: AMER SOC HEMATOLOGY, 2020, vol. 4, No 22, p. 5785-5796. ISSN 2473-9529. Available from: https://dx.doi.org/10.1182/bloodadvances.2020002731.
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Basic information
Original name The prospective Hemophilia Inhibitor PUP Study reveals distinct antibody signatures prior to FVIII inhibitor development
Authors REIPERT, B. M., B. GANGADHARAN, C. J. HOFBAUER, V. BERG, H. SCHWEIGER, J. BOWEN, Jan BLATNÝ (203 Czech Republic, belonging to the institution), K. FIJNVANDRAAT, E. S. MULLINS, J. KLINTMAN, C. MALE, C. MCGUINN, S. L. MEEKS, V. C. RADULESCU, M. V. RAGNI, M. RECHT, A. D. SHAPIRO, J. M. STABER, H. M. YAISH, E. SANTAGOSTINO and D. L. BROWN.
Edition BLOOD ADVANCES, WASHINGTON, AMER SOC HEMATOLOGY, 2020, 2473-9529.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30205 Hematology
Country of publisher Slovenia
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 6.686
RIV identification code RIV/00216224:14110/20:00117703
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1182/bloodadvances.2020002731
UT WoS 000593144300022
Keywords in English Hemophilia Inhibitor PUP; FVIII inhibitor development
Tags 14110321, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 12/1/2021 12:31.
Abstract
Preventing factor VIII (FVIII) inhibitors following replacement therapies with FVIII products in patients with hemophilia A remains an unmet medical need. Better understanding of the early events of evolving FVIII inhibitors is essential for risk identification and the design of novel strategies to prevent inhibitor development. The Hemophilia Inhibitor Previously Untreated Patients (PUPs) Study (HIPS; www. clinicaltrials.gov #NCT01652027) is the first prospective cohort study to evaluate comprehensive changes in the immune system during the first 50 exposure days ( EDs) to FVIII in patients with severe hemophilia A. HIPS participants were enrolled prior to their first exposure to FVIII or blood products ("true PUPs") and were evaluated for different immunological and clinical parameters at specified time points during their first 50 EDs to a single source of recombinant FVIII. Longitudinal antibody data resulting from this study indicate that there are 4 subgroups of patients expressing distinct signatures of FVIII- binding antibodies. Subgroup 1 did not develop any detectable FVIII-binding immunoglobulin G (IgG) antibodies. Subgroup 2 developed nonneutralizing, FVIII-binding IgG1 antibodies, but other FVIII-binding IgG subclasses were not observed. Subgroup 3 developed transient FVIII inhibitors associated with FVIII-binding IgG1 antibodies, similar to subgroup 2. Subgroup 4 developed persistent FVIII inhibitors associated with an initial development of high-affinity, FVIII-binding IgG1 antibodies, followed by IgG3 and IgG4 antibodies. Appearance of FVIII-binding IgG3 was always associated with persistent FVIII inhibitors and the subsequent development of FVIII-binding IgG4. Some of the antibody signatures identified in HIPS could serve as candidates for early biomarkers of FVIII inhibitor development.
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