Evidence for the benefits of prophylaxis in the management of hemophilia A

W. Keith Hoots; Diane J. Nugent

doi:10.1160/TH06-02-0125

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2006; 96(04): 433-440
DOI: 10.1160/TH06-02-0125

Review Article

Schattauer GmbH

Evidence for the benefits of prophylaxis in the management of hemophilia A

W. Keith Hoots

¹Department of Pediatrics and Internal Medicine, University of Texas Medical School, Houston, Texas, USA

²Department of Pediatrics, University of Texas – M.D. Anderson Cancer Center, Houston, Texas, USA

,

Diane J. Nugent

³Department of Hematology, Children’s Hospital of Orange County, Orange, California, USA

⁴Department of Pediatric Hematology Oncology, Mattel Children’s Hospital, UCLA Medical School, Los Angeles, California, USA

› Author Affiliations

Abstract

Summary

The optimal treatment of hemophilia has been evolving since the advent of factor VIII concentrates, continues to vary geographically, and remains a source of debate. There now exists an extensive clinical literature that demonstrates clear benefits of prophylaxis for patients with hemophilia A compared to on-demand treatment, including a reduction in the number of bleeding episodes, improved joint function, and greater patient well-being. However, the value of these benefits must be weighed against the heavier economic burden of increased factor use. This paper reviews the literature that compares the benefits of prophylaxis with that of on-demand treatment, compares varying prophylaxis dose and administration frequency protocols, and considers the long-term cost-benefit of prophylactic therapy.

Keywords

Hemophilia - prophylaxis - on-demand - factor VIII - arthropathy - cost-benefit

Full Text

References

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