Current dosing practices for perioperative factor VIII concentrate treatment in mild haemophilia A patients result in FVIII levels above target

Autor:	Nils de Rooij, Hendrika C A M Hazendonk, Reinier M. van Hest, Marjon H. Cnossen, Lisette M. Schütte, Ron A. A. Mathôt, Marieke J. H. A. Kruip, Frank W.G. Leebeek
Přispěvatelé:	Pharmacy, AGEM - Endocrinology, metabolism and nutrition, AGEM - Digestive immunity, AII - Inflammatory diseases, ACS - Pulmonary hypertension & thrombosis, Hematology, Pediatrics
Rok vydání:	2019
Předmět:	Adult Male congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Adolescent animal diseases Haemophilia A 030204 cardiovascular system & hematology Hemophilia A Target range Body weight Gastroenterology Young Adult 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Internal medicine medicine Humans In patient Dosing Child Perioperative Period Genetics (clinical) Aged Retrospective Studies Factor VIII Dose-Response Relationship Drug business.industry Dosing regimen Hematology General Medicine Perioperative Middle Aged medicine.disease Treatment Outcome Child Preschool Mild haemophilia A Female business 030215 immunology
Zdroj:	Haemophilia. Wiley-Blackwell Haemophilia, 25(6). Wiley-Blackwell Publishing Ltd
ISSN:	1365-2516 1351-8216
DOI:	10.1111/hae.13838
Popis:	Background: In patients with haemophilia A (HA) perioperative dosing of factor VIII (FVIII) concentrate is based on body weight, historical FVIII level, in vivo recovery and FVIII level target values. In moderate and severe HA patients, this dosing regimen frequently leads to perioperative FVIII levels below and above target. This has not yet been evaluated in mild HA patients. Objectives: To evaluate perioperative FVIII concentrate treatment in mild HA pa‐ tients and to assess the frequency of FVIII levels below or above target. Patients/Methods: This retrospective single‐centre study collected data from medi‐ cal files of mild HA patients undergoing surgery and treated with FVIII concentrate. FVIII levels were compared to their target ranges and predictive factors for levels outside the target ranges were determined by logistic regression. Results: Fifty surgeries performed in 34 patients were evaluated. Median age was 47 years and median historical FVIII level was 0.14 IU/mL. Preoperative peak FVIII level was above or below the target range in 80% and 6.7% of surgeries, respectively. Postoperatively, the percentages above and below target trough ranges were 55.8% and 12.8%. Patients with blood group 0 had the highest risk on the preoperative peak FVIII level being above target. In addition, patients who had a preoperative baseline FVIII level of >0.10 IU/mL higher than their historical FVIII level had a higher preop‐ erative peak FVIII level than patients without this increase. Conclusions: Dosing above FVIII target ranges with FVIII concentrates occurs fre‐ quently during perioperative treatment of mild HA patients. These results underline the necessity for better patient‐tailored treatment.
Databáze:	OpenAIRE
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