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What factors should influence the dosage and interval of prophylactic treatment in patients with severe haemophilia A and B?
Author(s) -
Petrini P.
Publication year - 2001
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/j.1365-2516.2001.00471.x
Subject(s) - medicine , haemophilia , arthropathy , trough level , pediatrics , prophylactic treatment , surgery , haemophilia a , haemophilia b , osteoarthritis , alternative medicine , pathology , transplantation , tacrolimus
In order to prevent arthropathy, prophylaxis has to start at a young age before recurrent joint bleedings have taken place. The use of central venous lines has facilitated an early beginning to treatment, but due to side‐effects, most European paediatricians prefer peripheral injections whenever possible. By starting primary prophylaxis at the age of 1–2 years with one injection weekly, the need for surgical implants may be reduced. In this study, only four of 34 boys born 1988–98 with severe haemophilia A or B needed a Port‐a‐Cath ® for primary prophylaxis. Trough levels were measured in these patients and 79% showed a trough level < 1%, while 21% reached a level > 1%. Despite this, joint bleedings during 1998 were rare in both groups [0–4] and 59% of the boys with trough levels < 1% did not report any haemartroses during that year. Mean annual joint bleedings were the same in both groups [0.70, 0.71]. The lowest effective level of factors VIII and IX must be determined individually for each patient on primary or secondary prophylaxis.