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Prophylaxis in Hemophilia A Patients with Inhibitors

dc.contributor.authorAntunes, M
dc.contributor.authorSantos, A
dc.contributor.authorDiniz, MJ
dc.date.accessioned2013-12-16T13:11:09Z
dc.date.available2013-12-16T13:11:09Z
dc.date.issued2013
dc.description.abstractThe development of antibodies to factor VIII is one of the most serious complications of haemophilia treatment. Approximately 30% of patients with severe haemophilia develop neutralizing inhibitors to replacement FVIII. Although most patients with inhibitors do not bleed more frequently than patients without inhibitors, bleeding is more difficult to control and this patients suffer more severe bleeding and have greater morbidity and mortality. Patients with persistent high-titer inhibitor who are not candidates or fail ITI, pose a great challenge to haemophilia management. The efficacy and safety of prophylaxis with bypassing agents in reducing bleeding tendency, has been described in numerous studies. Patients and methods: We report tree adult severe haemophilia A patients, two with persistent high-titre inhibitors and one who failed ITI, on prophylactic treatment after several significant musculoskeletal and life-threatening haemorrhagic episodes (intrabdominal/intramuscular) and pseudotumor haemorrhage. Treatment regimens consisted of APCC (Feiba®) in doses of 60-70UKg-1, 2-3 times per week, according underlying bleeding phenotype. Breakthrough bleeds were treated with either APCC (Feiba®) or rFVIIa (NovoSeven®). Results and Conclusion: There was reduction in total bleeding episodes in two patients (43% to 80%) and one patient remained stable, while receiving prophylaxis. Absence of severe and life threatening bleeding episodes, as well as inpatient stays, contributing to a better quality of life in those patients, was observed. APCC (Feiba®) was well tolerated and no thrombotic events were observed.por
dc.identifier.citationIN: Bayer HealthCare Hematology Conference; 2013, 17 a 19 Out. Lisboa, Portugalpor
dc.identifier.urihttp://hdl.handle.net/10400.17/1596
dc.language.isoengpor
dc.publisherServiço de Imunohemoterapia do Hospital de S. José, Centro Hospitalar de Lisboa Central, EPEpor
dc.subjectProfilaxiapor
dc.subjectHemofilia Apor
dc.subjectHSJ IMUpor
dc.titleProphylaxis in Hemophilia A Patients with Inhibitorspor
dc.typeother
dspace.entity.typePublication
rcaap.rightsopenAccesspor
rcaap.typeotherpor

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