Hemophilia Clinical Trial
Primary prophylaxis in severe hemophiliacs is defined that prophylaxis therapy starts before
2 years of age and prior to any clinically evident joint bleeding or after first joint
bleeding and prior to the onset of joint damage irrespective of age, joints can be kept
normal or very mildly damaged till teenage or adulthood. Primary prophylaxis has been proved
to be more beneficial and cause less damage to joint than "on-demand" therapy. Primary
prophylaxis is also known to be able to decrease the occurrence of factor VIII inhibitor and
is the most advanced and useful, cost-effective therapy for hemophilia care. However, it
requires 2 to 3 injections of factor VIII or IX of 20-50 IU/Kg doses every week, it costs a
lot of expenses. In the year 2013, we tried hard to discuss with Bureau of National Health
Insurance (BNHI) and have meeting a couple of time, eventually a guideline of an
intermediate-dose prophylaxis for severe hemophilia was established and a consensus was
reached that this prophylactic treatment will be cost effective without increased burden of
total budget. This guideline was finally approved by BNHI and will be implemented from July
1st, 2014. In oder to evaluate the efficacy of prophylaxis treatment, patients will be
arranged to come back to each hemophilia center at least once a year to have investigation
of doses and annual consumption of clotting factors, frequencies and causes of bleedings,
especially joint bleedings, joint outcome by studies of hemophilia joint health score
(HJHS), hemophilia actives list and health-related quality of life. These results will be
collected and compared between intermediate-dose prophylaxis group of patients and on demand
treatment group of patients.
The life span of hemophiliacs has been improved remarkably in recent years due to sufficient
and adequate treatments, especially prophylaxis treatment, therefore comorbidities in the
hemophilic population, e.g. hypertension, diabetes, hyperlipidemia and cancer, etc, have
been found with prevalences close to those in non-hemophilic population. It is worth that
the prevalence of these comorbidity will also be investigated. In addition, basic data of
the patients including age, sex, severity, the development of inhibitor and viral infection
etc will also be collected for analysis.
n/a
Observational Model: Cohort
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