血友病基因疗法:首先,没有伤害.
Leonard A Valentino1, Radoslaw Kaczmarek2, Glenn F Pierce3
1Rush University, Chicago, Illinois, USA; National Hemophilia Foundation, New York, New York, USA.
Journal of thrombosis and haemostasis : JTH
|June 23, 2023
概括
基因疗法为血友病治疗提供了新的希望,但由于历史上的安全问题,需要仔细考虑. 对于考虑用于血友病A和B的腺相关病毒基因治疗的患者来说,知情决策至关重要.
科学领域:
- 血液学 血液学 血液学
- 基因治疗 基因治疗
- 病毒载体 病毒载体
背景情况:
- 血友病社区有破坏性感染 (艾滋病毒,C型肝炎) 的历史,与过去的治疗方法 (如因子缩剂) 有关.
- 尽管有进展,但血友病治疗仍然面临着生存,生活质量和健康公平方面的挑战.
- 以腺相关病毒 (AAV) 为媒介,肝脏为导向的基因疗法代表了有前途和不确定性的重大进展.
研究的目的:
- 审查支持对血友病AAV基因疗法的监管授权的数据.
- 为患者和医疗保健专业人员提供基因治疗决策过程的概述.
- 建议采取措施,确保血友病基因治疗的安全性和最佳结果.
主要方法:
- 对临床试验数据的审查导致监管部门批准了valoctocogene roxaparvovec (血友病A) 和etranacogene dezaparvovec-drlb (血友病B).
- 分析与血友病治疗相关的历史安全数据.
- 在新型基因治疗的背景下,研究共享决策原则.
主要成果:
- 瓦洛克托基因roxaparvovec (AAV5基因疗法) 在欧洲授权用于血友病A.
- 在美国和欧洲,Etranacogene dezaparvovec-drlb已获准用于治疗B型血友病.
- 基因疗法提供了改善结果的潜力,但需要彻底,公正的决策过程.
结论:
- 通过AAV介导的基因疗法代表了血友病治疗的有前途的新时代.
- 对考虑基因治疗的患者来说,知情,共享的决策至关重要.
- 解决潜在的偏见和实施安全协议对于在血友病护理中成功采用基因疗法至关重要.
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