Browsing by Author "Holme, PA"
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- Non-Genetic Risk Factors and the Development of Inhibitors in Haemophilia: a Comprehensive Review and Consensus ReportPublication . Astermark, J; Altisent, C; Batorova, A; Diniz, MJ; Gringeri, A; Holme, PA; Karafoulidou, A; Lopez-Fernández, MF; Reipert, BM; Rocino, A; Schiavoni, M; von Depka, M; Windyga, J; Fijnvandraat, KThe development of inhibitors to the infused factor in patients with haemophilia is a serious clinical problem. Recent evidence suggests that alongside the strong genetic contribution to inhibitor formation, there are a number of non-genetic factors--perceived by the immune system as danger signals--which promote formation of inhibitors. This study provides a comprehensive review of clinical studies relating to these factors and also presents a survey of opinion concerning their importance and clinical influence, conducted among the members of the European Haemophilia Treatment Standardisation Board (EHTSB). Taken together, this information highlights the lack of robust data concerning the influence of several non-genetic risk factors on inhibitor development, and an urgent need for prospective, well-conducted studies that adhere to recommendations made by the European Medicines Agency (EMEA) for studying inhibitors. Based on current literature, the EHTSB formulated consensus recommendations. It is desirable to minimize intensive treatment wherever possible, given the clinical situation. Prophylaxis should be offered to all children, although we still need to determine optimal dosing with respect to inhibitor development, and age for starting treatment. Vaccinations should be given subcutaneously and concomitant factor concentrate infusions avoided. According to the board, there is no evidence in the literature supporting suggestions that the type of concentrate influences inhibitor risk; but all patients should be monitored during their first exposures. Furthermore, there is no evidence to support an association between pregnancy-related issues, breast feeding and treatment-related factors (e.g. route of administration, or use of blood components) and inhibitor development.
- The Second Team Haemophilia Education Meeting, 2016, Frankfurt, GermanyPublication . Berntorp, E; Dargaud, Y; Hart, D; Lobet, S; Mancuso, ME; d'Oiron, R; Perry, D; Pollard, D; van den Berg, M; Blatný, J; Chambost, H; Doria, AS; Holme, PA; Kaczmarek, R; Mantovani, L; McLaughlin, P; Nanayakkara, L; Petrini, P; Sannié, T; Laane, E; Maia, R; Dettoraki, A; Farrell, A; Halimeh, S; Raza, S; Taylor, SThe first Team Haemophilia Education (THE) Meeting was held on 7-8 May 2015 in Amsterdam, The Netherlands. It aimed to promote the optimal care of patients with haemophilia through education of the multidisciplinary treatment team. This was achieved by reviewing the latest developments in haemophilia management, considering how these can be implemented in the clinic to improve patient care and providing a platform for networking and debate for all haemophilia treatment team members. The second THE Meeting was held on 19-20 May in Frankfurt, Germany, and participants included doctors, nurses, physiotherapists, patient representatives and data management staff from 20 different countries. Topics covered the role of the multidisciplinary team in delivering the best haemophilia care, challenges in the management of haemophilia across Europe, available clotting factor treatments, future treatments and the use of genetics in advising carriers of haemophilia. This report is a summary of the key developments in haemophilia care presented by various investigators and healthcare professionals at THE Meeting 2016.