ABSTRACT
The development and introduction of recombinant factor VIII (rFVIII) concentrates
nearly 20 years ago represented a major advance in the treatment of hemophilia A patients.
Currently, first-, second- and third-generation rFVIII products are commercially available.
Whereas first-generation rFVIII concentrates are stabilized with human albumin, second-generation
rFVIII products contain sucrose instead of albumin in the final formulation. Finally,
third-generation rFVIII products are manufactured without additional human or animal
plasma proteins. The use of rFVIII concentrates has greatly improved the safety of
replacement therapy in hemophilia A and virtually abolished the risk of blood-borne
pathogen transmission. The remaining and most challenging aspect of hemophilia A management
has now become the development of FVIII inhibitors. In this article we review the
current knowledge on the commercially available rFVIII concentrates, analyzing their
main characteristics. Moreover, results of the literature on their clinical hemostatic
efficacy and safety are summarized.
KEYWORDS
rFVIII - bleeding - hemophilia - inhibitors
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Massimo FranchiniM.D.
Servizio di Immunoematologia e Trasfusione
Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
eMail: massimo.franchini@azosp.vr.it