European retrospective study of real‐life haemophilia treatment

• Published in: Haemophilia : the official journal of the World Federation of Hemophilia Vol. 23; no. 1; pp. 105 - 114
• Main Authors: Berntorp, E., Dolan, G., Hay, C., Linari, S., Santagostino, E., Tosetto, A., Castaman, G., Álvarez‐Román, MT, Parra Lopez, R., Oldenburg, J., Albert, T., Scholz, U., Holmström, M., Schved, J.‐F., Trossaërt, M., Hermans, C., Boban, A., Ludlam, C., Lethagen, S.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.01.2017; Wiley
• Subjects: Adult; Bleeding; Children; Clinical Medicine; Coagulation; Europe; Factor IX; Factor IX deficiency; Factor VIII; Haemophilia A; Haemophilia B; Hematologi; Hematology; Hemophilia; Hemophilia A - therapy; Human health and pathology; Humans; Klinisk medicin; Life Sciences; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Prophylaxis; Retrospective Studies; Retrospective study; Treatment; factor IX; treatment; haemophilia B; haemophilia A; factor VIII; retrospective study
• ISSN: 1351-8216; 1365-2516; 1365-2516
• DOI: 10.1111/hae.13111

Introduction Haemophilia treatment varies significantly between individuals, countries and regions and details of bleed rates, factor consumption and injection frequency are often not available. Aim To provide an overview of the FVIII/FIX treatment practice and outcome for patients with haemophilia A (HA) or haemophilia B (HB) across Europe. Methods Non‐interventional, 12‐month retrospective study where anonymized data were retrieved from haemophilia centres/registers in Belgium, France, Germany, Italy, Spain, Sweden and the United Kingdom. Male patients (all ages) receiving coagulation factor treatment 24 months prior to the study, with basal FVIII/FIX levels ≤5 IU dL−1, without inhibitors, were included. Data were summarized descriptively. Results In total, 1346 patients with HA and 312 with HB were included in the analysis; 75% and 57% had severe disease (FVIII/FIX < 1 IU dL−1) respectively. Prophylaxis was most common for severe haemophilia, especially for children, whereas on‐demand treatment was more common for moderate haemophilia in most countries. The mean (SD) prescribed prophylactic treatment ranged from 67.9 (30.4) to 108.4 (78.1) (HA) and 32.3 (10.2) to 97.7 (32.1) (HB) IU kg−1 per week, across countries. Most patients on prophylaxis were treated ≥3 times/week (HA) or two times/week (HB). The median annual bleeding rate (ABR) for patients on prophylaxis ranged from 1.0 to 4.0 for severe HA, and from 1.0 to 6.0 for severe HB, while those with moderate haemophilia generally had slightly higher ABRs. Median ABRs for on‐demand‐treated severe HA ranged from 4.5 to 18.0, and for HB, 1.5 to 14.0. Conclusion Treatment practice varied greatly between centres and countries and patients treated on‐demand and prophylactically both experienced bleeds, emphasizing the need for further optimization of care.