Evolving Complexity in Hemophilia Management

Pediatr Clin North Am. 2018 Jun;65(3):407-425. doi: 10.1016/j.pcl.2018.01.004.

Abstract

Rapid expansion of therapeutic options have increased the complexity of hemophilia care. Previously, on-demand therapy aimed to reduce morbidity and early mortality; however, now aggressive prophylaxis, particularly in children, encourages an active lifestyle. Accurate diagnosis, recognition of early threats to musculoskeletal health, and optimization of therapy are critical for both males and females affected by hemophilia. The diversity of emerging hemophilia therapies, from modified factor protein concentrates, to gene therapy, to nonfactor hemostatic strategies, provide an exciting opportunity to target unmet needs in the bleeding disorder community.

Keywords: Bispecific antibody; Bleeding; Factor IX; Factor VIII; Factor concentrate; Gene therapy; Hemarthrosis; Inhibitors.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Coagulants / therapeutic use
  • Factor IX / therapeutic use
  • Factor VIII / therapeutic use
  • Hemophilia A / diagnosis
  • Hemophilia A / etiology
  • Hemophilia A / therapy*
  • Hemophilia B / diagnosis
  • Hemophilia B / etiology
  • Hemophilia B / therapy*
  • Humans
  • Immunoglobulin Fc Fragments / therapeutic use
  • Immunologic Factors / therapeutic use
  • Recombinant Fusion Proteins / therapeutic use

Substances

  • Coagulants
  • Immunoglobulin Fc Fragments
  • Immunologic Factors
  • Recombinant Fusion Proteins
  • Factor VIII
  • Factor IX