Clinical Edge

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Preventing Bleeding in Patients with Hemophilia

Cochrane; 2017 Sep 25; Chai-Adisaksopha, et al

Publish date:

Bypassing agents may help lower bleeding in males with hemophilia who develop inhibitory antibodies, according to a Cochrane review of 4 studies involving 116 individuals. No agent was found to be better than another. 2 studies compared prophylactic infusion using a bypassing agent to treatment given after bleeding. The other 2 trials compared high- and low-dose preventive therapies. Among the findings, based on low-to-moderate evidence:

  • Bypassing agents reduced bleeding events, joint bleeding events, and number of affected joints.
  • Prophylactic therapy did not improve quality of life any better than on-demand therapy.
  • There was no evidence for a difference in benefits or harms between high- and low-dose recombinant activated FVII used prophylactically.

Citation:

Chai-Adisaksopha C, Nevitt S, Simpson M, Janbain M, Konkle B. Bypassing agent prophylaxis in people with hemophilia A or B with inhibitors. Cochrane Database of Syst Rev. 2017, Issue 9. Art. No.: CD011441. doi:10.1002/14651858.CD011441.pub2.

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