Open AccessIntermediate Dose Prophylaxis in Adults with Haemophilia: A Clinical Audit from a Resource Limited Setting
Author(s) -
Remya Sudevan,
Aswathy Ashok Beenakumari,
Rema Ganapathy,
Manoj Unni,
Geeta Vidyadharan,
Neeraj Sidharthan
Publication year - 2019
Publication title -
indian journal of hematology and blood transfusion/indian journal of hematology and blood transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.213
H-Index - 15
eISSN - 0974-0449
pISSN - 0971-4502
DOI - 10.1007/s12288-019-01189-4
Subject(s) - medicine , hematology , haemophilia , audit , clinical audit , medline , haemophilia a , family medicine , intensive care medicine , pediatrics , management , economics , political science , law
To address the scarcity of real world data on adult prophylaxis from developing world, a short term intermediate dose prophylaxis in adult haemophilia A patients was initiated. A total of eight patients aged > 18 years with moderate/severe haemophilia A were given an average dose of 23 IU/kg recombinant factor VIII (rFVIII) concentrate twice weekly for 2 months. A clinical audit was done on completion of four months. The mean age of the participants was 31.63 (± 6.98) years. The mean bleed rate during two months of episodic versus prophylactic regimen was 5.13 versus 0.63 ( p = 0.01) and that of work days lost, hospital visits for hemophilia care were 30.63 (± 24.69) versus zero days, 20.63 (± 16.19) versus zero days respectively. The mean of factor VIII consumed during prophylaxis was 13,500 IU/month (i.e., 23 IU/kg/dose).The median time gap between prophylactic infusion to trough level was 67.50 h (60-74 h) and the median trough level observed was 2.50% (range 1-5%). The results of our clinical audit show that Intermediate dose prophylaxis with rFVIII concentrates in young adult patients with moderate/severe haemophilia A appears to be effective in reducing the frequency of bleeds.