Inhibitor risk according to the type of recombinant FVIII (rFVIII) product (primary analysis)
. | No. of EDs . | Unadjusted analysis . | Multivariate analysis . | ||||
---|---|---|---|---|---|---|---|
Crude HR . | 95% CI . | P . | Adjusted HR . | 95% CI . | P . | ||
All inhibitors | .025* | .221* | |||||
Product E | 4995 | 1.00 | 1.00 | ||||
Product D | 4749 | 1.61 | 1.04-2.47 | .031 | 1.55 | 0.97-2.49 | .069 |
Product A | 2074 | 0.69 | 0.34-1.40 | .300 | 0.97 | 0.40-2.37 | .952 |
Product C | 1412 | 0.93 | 0.43-2.02 | .864 | 1.20 | 0.47-3.08 | .705 |
High-titer inhibitors | .489* | .547* | |||||
Product E | 4995 | 1.00 | 1.00 | ||||
Product D | 4749 | 1.42 | 0.79-2.52 | .240 | 1.56 | 0.82-2.98 | .177 |
Product A | 2074 | 0.83 | 0.35-1.97 | .673 | 1.87 | 0.59-5.89 | .286 |
Product C | 1412 | 1.02 | 0.38-2.74 | .963 | 1.94 | 0.54-6.91 | .307 |
Inhibitors subsequently treated with a bypassing agent and/or ITI | .019* | .165* | |||||
Product E | 4995 | 1.00 | 1.00 | ||||
Product D | 4749 | 1.61 | 1.01-2.56 | .046 | 1.58 | 0.94-2.64 | .082 |
Product A | 2074 | 0.49 | 0.20-1.17 | .108 | 0.81 | 0.28-2.35 | .705 |
Product C | 1412 | 1.11 | 0.50-2.43 | .799 | 1.67 | 0.62-4.51 | .311 |
. | No. of EDs . | Unadjusted analysis . | Multivariate analysis . | ||||
---|---|---|---|---|---|---|---|
Crude HR . | 95% CI . | P . | Adjusted HR . | 95% CI . | P . | ||
All inhibitors | .025* | .221* | |||||
Product E | 4995 | 1.00 | 1.00 | ||||
Product D | 4749 | 1.61 | 1.04-2.47 | .031 | 1.55 | 0.97-2.49 | .069 |
Product A | 2074 | 0.69 | 0.34-1.40 | .300 | 0.97 | 0.40-2.37 | .952 |
Product C | 1412 | 0.93 | 0.43-2.02 | .864 | 1.20 | 0.47-3.08 | .705 |
High-titer inhibitors | .489* | .547* | |||||
Product E | 4995 | 1.00 | 1.00 | ||||
Product D | 4749 | 1.42 | 0.79-2.52 | .240 | 1.56 | 0.82-2.98 | .177 |
Product A | 2074 | 0.83 | 0.35-1.97 | .673 | 1.87 | 0.59-5.89 | .286 |
Product C | 1412 | 1.02 | 0.38-2.74 | .963 | 1.94 | 0.54-6.91 | .307 |
Inhibitors subsequently treated with a bypassing agent and/or ITI | .019* | .165* | |||||
Product E | 4995 | 1.00 | 1.00 | ||||
Product D | 4749 | 1.61 | 1.01-2.56 | .046 | 1.58 | 0.94-2.64 | .082 |
Product A | 2074 | 0.49 | 0.20-1.17 | .108 | 0.81 | 0.28-2.35 | .705 |
Product C | 1412 | 1.11 | 0.50-2.43 | .799 | 1.67 | 0.62-4.51 | .311 |
Population: boys with severe HA (FVIII activity <0.01 IU/mL) first treated with rFVIII and treated with Products A, C, D, or E within the first 75 EDs (n = 287). Products B and F were used only in 10 and 10 boys and 331 and 483 EDs, respectively, so their effect on inhibitor development was not studied. Main studied factor: type of rFVIII product received during the first 75 EDs (time-varying factor). Statistical method: Cox proportional hazards model with ED as observational time. aHR took into account the following cofactors: 4 fixed factors (F8 gene defect, family history of hemophilia and inhibitor, ethnic origin, and age at first infusion of rFVIII) and 7 time-varying factors (calendar period, regular prophylaxis initiation, interval between EDs calculated over the last 5 EDs, mean dose of rFVIII product calculated over the last 5 EDs, history of peak treatment episodes ≥5 consecutive EDs, history of peak treatment episodes ≥10 consecutive EDs, and history of severe bleeding episodes).
P value for global test.