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Anti-inhibitor coagulant complex prophylaxis in hemophilia with inhibitors
- Publication Year :
- 2011
- Publisher :
- Massachussetts Medical Society, 2011.
-
Abstract
- BACKGROUND: Patients with severe hemophilia A and factor VIII inhibitors are at increased risk for serious bleeding complications and progression to end-stage joint disease. Effective strategies to prevent bleeding in such patients have not yet been established. METHODS: We enrolled patients with hemophilia A who were older than 2 years of age, had high-titer inhibitors, and used concentrates known as bypassing agents for bleeding in a prospective, randomized, crossover study comparing 6 months of anti-inhibitor coagulant complex (AICC), infused prophylactically at a target dose of 85 U per kilogram of body weight (±15%) on 3 nonconsecutive days per week, with 6 months of on-demand therapy (AICC at a target dose of 85 U per kilogram [±15%] used for bleeding episodes). The two treatment periods were separated by a 3-month washout period, during which patients received on-demand therapy for bleeding. The primary outcome was the number of bleeding episodes during each 6-month treatment period. RESULTS: Thirty-four patients underwent randomization; 26 patients completed both treatment periods and could be evaluated per protocol for the efficacy analysis. As compared with on-demand therapy, prophylaxis was associated with a 62% reduction in all bleeding episodes (P
- Subjects :
- Adult
Male
Health Services Research, Adolescent
medicine.medical_specialty
Adolescent
MED/42 - IGIENE GENERALE E APPLICATA
Hemorrhage
Hemophilia A
Drug Administration Schedule
Statistics, Nonparametric
Joint disease
Young Adult
Anti-Inhibitor Coagulant Complex
Internal medicine
medicine
Humans
Prospective Studies
Young adult
Prospective cohort study
Child
Aged
Bleeding episodes
Cross-Over Studies
Factor VIII
business.industry
Medicine (all)
General Medicine
Cross-Over Studie
Middle Aged
Crossover study
Treatment period
Blood Coagulation Factors
Surgery
Target dose
Prospective Studie
Child, Preschool
Female
business
Blood Coagulation Factor
Human
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....5358cc56fd9c8051850cd0a97daf7026