Prevention of bleeding in patients with hemophilia

April 23, 2021
934
Resume

Management of patients with severe hemophilia A and B remains a complex problem in clinical medicine due to the high frequency of antibodies against deficient factors. The solution may be the use of drugs with a shunt mechanism of action, namely activated eptacog alfa (rFVIIa) and antiinhibitory coagulation complex of blood coagulation factors II, VII, IX, X. The effectiveness of antiinhibitory coagulation complex has been proven by international randomized clinical trials — about 80%. Its significant advantage is a long half-life — up to 8–12 hours. From the modern point of view, the principles of application of the antiinhibitory coagulation complex for the purpose of prevention of bleeding episodes are important. According to the results of international randomized clinical trials, its prophylactic use is maximum effective, which involves the introduction of a dose of 80–85 IU/kg 3 times a week.

References:

  • 1. Giangrande P.L.F., Hermans C., O’Mahony B. et al. (2018) European principles of inhibitor management in patients with haemophilia. Orphanet. J. Rare Dis., 13: 66. https://doi.org/10.1186/s13023-018-0800-z
  • 2. Srivastava A., Santagostino E., Dougall A. et al. (2020) WFH Guidelines for the Management of Hemophilia, 3rd ed. Haemophilia, 26 (Suppl. 6): 1–158. doi: 10.1111/hae.14046
  • 3. Vydyborets S.V., Derpak Yu.Yu., Popovich Yu.Yu. (2018) Hemophilia. Family medicine, 6(80): 61–66. (In Ukr.).
  • 4. Stasyshyn O.V. (2021) Individualized approach to factor therapy of hemophilia: possibilities of modern technologies. Ukr. Med. J., 1(141): 1. DOI: 10.32471/umj.1680-3051.141.197253 (In Ukr.).
  • 5. Franchini M., Coppola A., Tagliaferri A. et al. (2013) FEIBA versus NovoSeven in Hemophilia Patients with Inhibitors. Semin. Thromb. Hemost., 39: 772–778. DOI http://dx.doi.org/10.1055/s-0033-1354425
  • 6. Antunes S.V., Tangada S., Stasyshyn O. et al. (2014) Randomized comparison of prophylaxis and on-demand regimens with FEIBA NF in the treatment of haemophilia A and B with inhibitors. Haemophilia, 20: 65–72. DOI: 10.1111/hae.12246