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- Title
Prophylaxis in Patients with Severe Hemophilia and Inhibitor.
- Authors
Jimenez-Yuste, Victor; Alvarez, Maria Teresa; Martin-Salces, Monica; Rodriguez-Merchan, E. Carlos; Butta, Nora; Fernandez-Bello, Ihosvany; Rivas, Isabel; Rodriguez de la Rua, Ana
- Abstract
Joint hemorrhage, the most common manifestation of severe hemophilia, frequently leads to recurrent hemarthrosis, chronic synovitis, and arthropathy. The main goal of replacement therapy is to prevent this pathology. On-demand treatment slows, but does not prevent, the progression of arthropathy. It has been shown that prophylaxis is superior to enhanced, episode-based therapy in preventing joint damage. However, patients often develop antibodies that inhibit or neutralize factor VIII (FVIII) or factor IX (FIX) replacement therapy in what is today the most serious complication of hemophilia and its treatment. The effects of bypassing agents in treating the bleeding episodes are not as predictable as those of replacement therapy with the deficient factor in patients with inhibitors. Consequently, these patients have higher levels of arthropathy than patients without inhibitors. Prophylaxis for patients with inhibitors has gained attention over the last decade, and some papers have reported that bypassing agents may help to prevent arthropathy. Nevertheless, the justification of prophylaxis in patients with inhibitors is still questioned because of concerns regarding its cost, complications, and efficacy.
- Subjects
DENTAL prophylaxis; HEMOPHILIACS; JOINT diseases; SYNOVITIS; BLOOD coagulation factor VIII antibodies; HEMOPHILIA treatment; HEMORRHAGE complications; CLINICAL trials; RETROSPECTIVE studies
- Publication
Journal of Coagulation Disorders, 2009, Vol 1, Issue 1, p1
- ISSN
2041-7969
- Publication type
Article