Prevalent inhibitors in haemophilia B subjects enrolled in the Universal Data Collection database

Several risk factors for inhibitors have recently been described for haemophilia A. It has been assumed that similar risk factors are also relevant for haemophilia B, but there is limited data to confirm this notion. The aim of this study was to determine the prevalence of and risk factors associated with inhibitors in haemophilia B. The database of the Universal Data Collection (UDC) project of the Centers for Disease Control for the years 1998–2011 was queried to determine the prevalence of inhibitors in haemophilia B subjects. In addition, disease severity, race/ethnicity, age, factor exposure and prophylaxis usage were evaluated to determine their impact on inhibitor prevalence. Of the 3785 male subjects with haemophilia B enrolled in the UDC database, 75 (2%) were determined to have an inhibitor at some point during the study period. Severe disease (OR 13.1, 95% CI 6.2–27.7), black race (OR 2.2, 95% CI 1.2–4.1), and age <11 years (OR 2.5, 95% CI 1.5–4.0) were found to be significantly associated with having an inhibitor. There was insufficient data to determine if type of factor used and prophylaxis were associated with inhibitors. Inhibitors in haemophilia B are much less prevalent than haemophilia A, especially in patients with mild disease. Similar factors associated with inhibitors in haemophilia A also seem to be present for haemophilia B. The information collected by this large surveillance project did not permit evaluation of potential risk factors related to treatment approaches and exposures, and additional studies will be required.

[1]  R. Presley,et al.  Increased prevalence of inhibitors in Hispanic patients with severe haemophilia A enrolled in the Universal Data Collection database , 2012, Haemophilia : the official journal of the World Federation of Hemophilia.

[2]  M. Recht,et al.  A retrospective study to describe the incidence of moderate to severe allergic reactions to factor IX in subjects with haemophilia B , 2011, Haemophilia : the official journal of the World Federation of Hemophilia.

[3]  Meredith A Oakley,et al.  The universal data collection surveillance system for rare bleeding disorders. , 2010, American journal of preventive medicine.

[4]  I. Warrier,et al.  Inhibitors in factor IX deficiency a report of the ISTH‐SSC international FIX inhibitor registry (1997–2006) , 2009, Haemophilia : the official journal of the World Federation of Hemophilia.

[5]  E. Santagostino,et al.  Risk stratification for inhibitor development at first treatment for severe hemophilia A: a tool for clinical practice , 2008, Journal of thrombosis and haemostasis : JTH.

[6]  P. Mannucci,et al.  Factor VIII products and inhibitor development: the SIPPET study (survey of inhibitors in plasma‐product exposed toddlers) , 2007, Haemophilia : the official journal of the World Federation of Hemophilia.

[7]  D. DiMichele Inhibitor development in haemophilia B: an orphan disease in need of attention , 2007, British journal of haematology.

[8]  J. Astermark Why do inhibitors develop? Principles of and factors influencing the risk for inhibitor development in haemophilia , 2006, Haemophilia : the official journal of the World Federation of Hemophilia.

[9]  T. Lambert,et al.  Influence of the type of factor VIII concentrate on the incidence of factor VIII inhibitors in previously untreated patients with severe hemophilia A. , 2006, Blood.

[10]  V. Blanchette,et al.  The safety and efficacy of recombinant human blood coagulation factor IX in previously untreated patients with severe or moderately severe hemophilia B. , 2005, Blood.

[11]  G. Castaldo,et al.  Molecular genotyping of the Italian cohort of patients with hemophilia B. , 2005, Haematologica.

[12]  M. Haase Human recombinant factor IX: safety and efficacy studies in hemophilia B patients previously treated with plasma-derived factor IX concentrates. , 2002, Blood.

[13]  J. Katz,et al.  The North American Immune Tolerance Registry: Practices, Outcomes, Outcome Predictors , 2002, Thrombosis and Haemostasis.

[14]  F. Rosendaal,et al.  Definitions in Hemophilia , 2001, Thrombosis and Haemostasis.

[15]  J. Katz Prevalence of factor IX inhibitors among patients with haemophilia B: results of a large‐scale North American survey , 1996, Haemophilia : the official journal of the World Federation of Hemophilia.

[16]  J. Goedert,et al.  Loss of high‐responder inhibitors in patients with severe hemophilia A and human immunodeficiency virus type 1 infection: A report from the multi‐center hemophilia cohort study , 1993, American journal of hematology.

[17]  E. Briët,et al.  Inhibitors in Christmas disease. , 1984, Progress in clinical and biological research.