Setting the stage for individualized therapy in hemophilia: What role can pharmacokinetics play?
| Autor: | Marjon H. Cnossen, Peter William Collins, Ron A. A. Mathôt, Karin Fijnvandraat, Frank W.G. Leebeek, Hendrika C A M Hazendonk, I. van Moort |
|---|---|
| Přispěvatelé: | Pediatrics, Hematology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Pharmacy, Other Research, ARD - Amsterdam Reproduction and Development, ACS - Amsterdam Cardiovascular Sciences, Paediatric Infectious Diseases / Rheumatology / Immunology, ACS - Pulmonary hypertension & thrombosis |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Hemorrhage 030204 cardiovascular system & hematology Hemophilia A Hemophilia B Factor IX 03 medical and health sciences 0302 clinical medicine Pharmacokinetics Quality of life Medicine Humans Dosing Disease management (health) Precision Medicine Intensive care medicine Clotting factor Factor VIII business.industry Research Disease Management Hematology Oncology Coagulation Concomitant business 030215 immunology Blood sampling |
| Zdroj: | Blood Reviews, 32(4), 265-271. Churchill Livingstone Blood reviews, 32(4), 265-271. Churchill Livingstone |
| ISSN: | 1532-1681 0268-960X |
| Popis: | Replacement therapy with clotting factor concentrates (CFC) is the mainstay of treatment in hemophilia. Its widespread application has led to a dramatic decrease in morbidity and mortality in patients, with concomitant improvement of quality of life. However, dosing is challenging and costs are high. This review discusses benefits and limitations of pharmacokinetic (PK)-guided dosing of replacement therapy as an alternative for current dosing regimens. Dosing of CFC is now primarily based on body weight and based on its in vivo recovery (IVR). Benefits of PK-guided dosing include individualization of treatment with better targeting, more flexible blood sampling, increased insight into association of coagulation factor levels and bleeding, and potential overall lowering of overall costs. Limitations include a slight burden for the patient, and availability of closely collaborating, experienced clinical pharmacologists. |
| Databáze: | OpenAIRE |
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