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Prevention of haemophilic synovitis: prophylaxis
Author(s) -
LEE C. A.
Publication year - 2007
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.1365-2516.2007.01536.x
Subject(s) - medicine , haemophilia , randomized controlled trial , intensive care medicine , bleed , pediatrics , cohort , surgery
Summary. It has been proven that early prophylactic therapy can prevent bleeding and arthropathy. Numerous retrospective non‐randomized cohort studies have demonstrated that prophylaxis, if started early in life, is associated with a considerable reduction of the mean number of joint bleeds and the rate of joint deterioration. It is quite extraordinary that despite the considerable evidence base it has been considered necessary by investigators to pursue the ideal of the controlled randomized trial and expose children to the risk of cerebral bleed. This questionable ethical approach is driven by the reluctance of the ‘willingness to pay’ but it is important that patients are not subjected to unnecessary investigation at either the behest of the Cochrane Database or those who control the financing of haemophilia care.