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The current status of prophylactic replacement therapy in children and adults with haemophilia
Author(s) -
Ljung Rolf,
Gretenkort Andersson Nadine
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13365
Subject(s) - medicine , haemophilia , bleed , observational study , clotting factor , prophylactic treatment , pediatrics , venous access , intensive care medicine , haemophilia a , surgery , catheter
Summary Initiating prophylactic treatment at an early age is considered to be the optimal form of therapy for a child with haemophilia A or B. The pioneering long term experiences of prophylactic treatment from Sweden and The Netherlands demonstrated the benefit of prophylaxis in retrospective and observational studies. Decades later, these benefits were confirmed in a randomized controlled study in USA . We review the current status of prophylactic replacement therapy of haemophilia in children, adolescents, adults and the elderly. Prophylaxis should begin at an early age and there are arguments for continuing it into adulthood. The dose of prophylaxis is dependent on the goal of treatment, economic resources and venous access and should be tailored individually. Starting the first exposures to clotting factor concentrates as prophylactic treatment, instead of on‐demand in response to a bleed, may decrease the frequency of inhibitors in patients with haemophilia A. Novel longer‐acting products are being introduced that could be helpful for patients with difficult venous access and enable higher trough levels.