J A Mason1,2, S Parikh1, H Tran1,3,4, J Rowell1,2, S McRae1,2,5. 1. Australian Haemophilia Centre Directors Organisation (AHCDO), Melbourne, Vic., Australia. 2. Queensland Haemophilia Centre, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. 3. Ronald Sawyers Haemophilia Centre, The Alfred Hospital, Melbourne, Vic., Australia. 4. Australian Centre for Blood Diseases, Monash University, Melbourne, Vic., Australia. 5. Department of Haematology, South Australia Pathology, Royal Adelaide Hospital, Adelaide, SA, Australia.
Abstract
INTRODUCTION: With the emergence of novel treatment products for haemophilia and an increasing focus on the benefits of pharmacokinetic driven individualized prophylaxis, robust national data with regard to current patterns of factor consumption and adherence are required. AIM: To characterize current Australian practice with regard to use of prophylactic clotting factor infusions in patients with moderate or severe haemophilia A (HA) and haemophilia B (HB). METHODS: This was a retrospective, non-interventional study utilizing Australian Bleeding Disorder Registry (ABDR) data collected over a 12 month period. Registered and consented patients with moderate or severe HA or HB without inhibitors were included. RESULTS: A total of 718 HA (551 severe, 167 moderate) and 166 HB (87 severe, 79 moderate) patients were included. Regular prophylaxis was prescribed in 453 patients (82%) with severe HA, 42 patients (25%) with moderate HA, 66 patients (75%) with severe HB and 11 patients (14%) with moderate HB. Near universal prophylaxis was achieved in the paediatric subgroup. The mean weekly dose of factor VIII in severe HA was 84 international units/kg/wk (IU/kg/wk) vs 71 IU/kg/wk of factor IX in severe HB. Most patients on prophylaxis were treated ≥3 times/wk (HA) or 2 times/wk (HB). Non-adherence peaked in the 20-29 year age group. Older individuals on regular prophylaxis used more factor than was expected for their prescribed regimen. CONCLUSION: Prophylaxis rates in severe haemophilia are comparable with other developed nations. The benefit of a national registry is demonstrable. Furthermore research into the underlying reasons for non-compliance in young adults with haemophilia is required.
INTRODUCTION: With the emergence of novel treatment products for haemophilia and an increasing focus on the benefits of pharmacokinetic driven individualized prophylaxis, robust national data with regard to current patterns of factor consumption and adherence are required. AIM: To characterize current Australian practice with regard to use of prophylactic clotting factor infusions in patients with moderate or severe haemophilia A (HA) and haemophilia B (HB). METHODS: This was a retrospective, non-interventional study utilizing Australian Bleeding Disorder Registry (ABDR) data collected over a 12 month period. Registered and consented patients with moderate or severe HA or HB without inhibitors were included. RESULTS: A total of 718 HA (551 severe, 167 moderate) and 166 HB (87 severe, 79 moderate) patients were included. Regular prophylaxis was prescribed in 453 patients (82%) with severe HA, 42 patients (25%) with moderate HA, 66 patients (75%) with severe HB and 11 patients (14%) with moderate HB. Near universal prophylaxis was achieved in the paediatric subgroup. The mean weekly dose of factor VIII in severe HA was 84 international units/kg/wk (IU/kg/wk) vs 71 IU/kg/wk of factor IX in severe HB. Most patients on prophylaxis were treated ≥3 times/wk (HA) or 2 times/wk (HB). Non-adherence peaked in the 20-29 year age group. Older individuals on regular prophylaxis used more factor than was expected for their prescribed regimen. CONCLUSION: Prophylaxis rates in severe haemophilia are comparable with other developed nations. The benefit of a national registry is demonstrable. Furthermore research into the underlying reasons for non-compliance in young adults with haemophilia is required.
Authors: Cihan Ay; Clemens Feistritzer; Joachim Rettl; Gerhard Schuster; Anna Vavrovsky; Leonard Perschy; Ingrid Pabinger Journal: Sci Rep Date: 2021-06-21 Impact factor: 4.379
Authors: Saunya Dover; Victor S Blanchette; Darius Wrathall; Eleanor Pullenayegum; Daniel Kazandjian; Byron Song; Sue Ann Hawes; Stéphanie Cloutier; Geroges E Rivard; Robert J Klaassen; Elizabeth Paradis; Nicole Laferriere; Ann Marie Stain; Anthony K Chan; Sara J Israels; Roona Sinha; MacGregor Steele; John K M Wu; Brian M Feldman Journal: Res Pract Thromb Haemost Date: 2020-01-29