Various regimens for prophylactic treatment of patients with haemophilia

Research output: Contribution to journalReview article

Abstract

Haemophilia prophylaxis is superior to on-demand treatment to prevent joint damage. High-dose prophylaxis' as used in Sweden is more effective in preventing arthropathy than an intermediate-dose regimen' (the Netherlands) and the Canadian tailored primary prophylaxis. Prophylaxis may reduce the risk of developing inhibitors. There is no difference in inhibitor risk between plasma derived and recombinant factor VIII (rFVIII) products but the Rodin study showed increased risk with second-generation rFVIII products. MRI is a new and very sensitive tool to detect the symptoms of early arthropathy but some results (soft tissue changes in bleed-free joints') still need to be investigated. Ultrasound is a very helpful method to aid diagnosis especially during the acute phase of a bleed. The risk of infection with central venous access remains a matter of debate. A fully implanted central venous access device (CVAD) has a significant lower risk of infection compared to external CVADs. Patient's age under 6yr and inhibitor presence are additional risk factors for infections. The role of arteriovenous fistulae needs to be investigated because significant complications have been reported. Disease-specific quality of life instruments are complementary to generic instruments evaluating QoL in patients with haemophilia and have become important health outcome measures.

Details

Authors
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology

Keywords

  • prophylaxis, children, haemophilia, treatment, inhibitors
Original languageEnglish
Pages (from-to)11-16
JournalEuropean Journal of Haematology
Volume94
Publication statusPublished - 2015
Publication categoryResearch
Peer-reviewedYes