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How do we optimally utilize factor concentrates in persons with hemophilia?
- Source :
-
Hematology. American Society of Hematology. Education Program [Hematology Am Soc Hematol Educ Program] 2021 Dec 10; Vol. 2021 (1), pp. 206-214. - Publication Year :
- 2021
-
Abstract
- The current mainstay of therapy for hemophilia is to replace the deficient clotting factor with the intravenous administration of exogenous clotting factor concentrates. Prophylaxis factor replacement therapy is now considered the standard of care in both pediatric and adult patients with hemophilia with a severe phenotype to protect musculoskeletal health and improve quality of life. Heterogeneity in bleeding presentation among patients with hemophilia due to genetic, environmental, and treatment-related factors has been well described. Accordingly, the World Federation of Hemophilia recommends an individualized prophylaxis regimen that considers the factors mentioned above to meet the clinical needs of the patient, which can vary over time. This review focuses on the practical points of choosing the type of factor concentrate, dose, and interval while evaluating appropriate target trough factor levels and bleeding triggers such as level of physical activity and joint status. We also discuss the use of a pharmacokinetics assessment and its incorporation in the clinic for a tailored approach toward individualized management. Overall, adopting an individualized prophylaxis regimen leads to an optimal utilization of factor concentrates with maximum efficacy and minimum waste.<br /> (Copyright © 2021 by The American Society of Hematology.)
- Subjects :
- Adolescent
Factor IX administration & dosage
Factor VIII administration & dosage
Hemophilia A complications
Hemophilia B complications
Hemorrhage etiology
Hemorrhage prevention & control
Hemostasis drug effects
Humans
Male
Quality of Life
Factor IX therapeutic use
Factor VIII therapeutic use
Hemophilia A therapy
Hemophilia B therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1520-4383
- Volume :
- 2021
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Hematology. American Society of Hematology. Education Program
- Publication Type :
- Academic Journal
- Accession number :
- 34889393
- Full Text :
- https://doi.org/10.1182/hematology.2021000310