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Vol. 32, Suppl. 1, 2002
Issue release date: 2002
Pathophysiol Haemost Thromb 2002;32(suppl 1):5–8

The Evidence behind Inhibitor Treatment with Porcine Factor VIII

Lee C.A.
The Haemophilia Centre and Haemostasis Unit, Royal Free Hospital NHS Trust, London, UK
email Corresponding Author

 goto top of outline Key Words

  • Porcine FVIII
  • Inhibitor
  • Pharmacokinetics
  • Hybrid FVIII
  • Acquired

 goto top of outline Abstract

Factor VIII auto- and alloantibodies neutralise porcine factor VIII to a lesser extent than factor VIII of human origin. The reduced reactivity of the porcine molecule, predominantly due to sequence variation in the A2 and C2 domains, has been the rationale for using porcine factor VIII to secure haemostasis for patients with factor VIII inhibitors. Porcine factor VIII has been shown to provide effective haemostatic control particularly for patients with intermediate inhibitor titres with limited porcine cross-reactivity. Small studies have indicated porcine factor VIII can be associated with desensitisation of some factor VIII inhibitor patients. Porcine factor VIII has been shown to produce mild platelet agglutination, an effect that may enhance its efficacy. Adverse reactions are dose-related and do not preclude safe and effective long-term home use for the subgroup of inhibitor patients with modest or absent anamnestic response. Efforts to secure source plasma free of viral markers, particularly porcine parvovirus, have limited the supply of this therapeutic product.

Copyright © 2002 S. Karger AG, Basel

 goto top of outline References
  1. Kernoff PB, Thomas ND, Lilley PA, Matthews KB, Goldman E, Tuddenham EG: Clinical experience with polyelectrolyte-fractionated porcine factor VIII concentrate in the treatment of hemophiliacs with antibodies to factor VIII. Blood 1984;663:31–41.
  2. Brettler DB, Forsberg AD, Levine PH, Aledort LM, Hilgartner MW, Kasper CK, Lusher JM, McMillan C, Roberts H: The use of porcine factor VIII concentrate (Hyate:C) in the treatment of patients with inhibitor antibodies to factor VIII. A multicenter US experience. Arch Intern Med 1989;149:1381–1385.

    External Resources

  3. Hay CR, Lozier JN, Lee CA, Laffan M, Tradati F, Santagostino E, Ciavarella N, Schiavoni M, Fukui H, Yoshioka A, Tietel J, Mannucci PM, Kasper CK: Safety profile of porcine factor VIII and its use as hospital and home-therapy for patients with haemophilia A and inhibitors: The results of an international survey. Thromb Haemost 1996;75:25–29.

    External Resources

  4. Hay CR, Laurian Y, Verroust F, Preston FE, Kernoff PB: Induction of immune tolerance in patients with hemophilia A and inhibitors treated with porcine VIIIC by home therapy. Blood 1990;76:882–886.
  5. Vyas P, Pasi KJ, Lee CA: Successful long-term treatment with porcine factor VIII of a patient with haemophilia A and an inhibitor to factor VIII. Haemophilia 1996;2:240–243.
  6. Morrison AE, Ludlam CA, Kessler C: Use of porcine factor VIII in the treatment of patients with acquired hemophilia. Blood 1993;81:1513–1520.
  7. Hermans C, Owens D, Longo G, Morfini M, Lee C.A: Single-dose pharmacokinetics of porcine factor VIII (Hyate C). Thromb Haemost 2002;87:352–353.

    External Resources

  8. Lollar P, Parker ET, Curtis JE, Helgerson SL, Hoyer LW, Scott ME, Scandella D: Inhibition of human factor VIIIa by anti-A2 subunit antibodies. J Clin Invest 1994;93:2497–2504.
  9. Arai, M, Scandella D, Hoyer LW: Molecular basis of factor VIII inhibition by human antibodies. Antibodies that bind to the factor VIII light chain prevent the interaction of factor VIII with phospholipid. J Clin Invest 1989;83:1978–1984.

    External Resources

  10. Lollar P: Analysis of factor VIII inhibitors using hybrid human/porcine factor VIII. Thromb Haemost 1997;78:647–651.
  11. Hay CRM, DiMichele D, Rivard G, Rubinger M, Gribble J: Workshop III – porcine factor VIII – continuous infusion, immune tolerance induction and prophylaxis. Haemophilia 1997;3(suppl 3):24–30.

 goto top of outline Author Contacts

Prof. Christine Lee, Centre Director
Royal Free Hospital, Pond Street
London, NW3 2QG (UK)
Tel. +44 207 7830 2238, Fax +44 207 7830 2468, E-Mail

 goto top of outline Article Information

Number of Print Pages : 4
Number of Figures : 2, Number of Tables : 0, Number of References : 11

 goto top of outline Publication Details

Pathophysiology of Haemostasis and Thrombosis
Official Journal of the ‘Mediterranean League against Thromboembolic Diseases’

Vol. 32, No. Suppl. 1, Year 2002 (Cover Date: Released April 2002)

Journal Editor: H.C. Hemker, Maastricht
ISSN: 1424–8832 (print), 1424–8840 (Online)

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