Evaluating the Effectiveness of Prophylactic Strategies for Hemophilia A Management: A Real-World, Longitudinal Observational Study

Abstract Background Hemophilia A (HA) treatment strategies aim to manage bleeding episodes and improve patients' quality of life. This study investigates the effectiveness of a preventative approach using intermediate-dose prophylaxis with standard half-life FVIII products in reducing bleeding...

Full description

Saved in:
Bibliographic Details
Main Authors: Shyh-Shin Chiou, Ching-Yeh Lin, Te-Fu Weng, Jiaan-Der Wang, Sheng-Chieh Chou, Ching-Tien Peng, Pei-Chin Lin, Yu-Mei Liao, Leanne Lai, Ming-Ching Shen, Taiwan Society of Thrombosis, Hemostasis (TSTH) Study Group
Format: Article
Language:English
Published: Adis, Springer Healthcare 2024-11-01
Series:Drugs - Real World Outcomes
Online Access:https://doi.org/10.1007/s40801-024-00452-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846147451093778432
author Shyh-Shin Chiou
Ching-Yeh Lin
Te-Fu Weng
Jiaan-Der Wang
Sheng-Chieh Chou
Ching-Tien Peng
Pei-Chin Lin
Yu-Mei Liao
Leanne Lai
Ming-Ching Shen
Taiwan Society of Thrombosis, Hemostasis (TSTH) Study Group
author_facet Shyh-Shin Chiou
Ching-Yeh Lin
Te-Fu Weng
Jiaan-Der Wang
Sheng-Chieh Chou
Ching-Tien Peng
Pei-Chin Lin
Yu-Mei Liao
Leanne Lai
Ming-Ching Shen
Taiwan Society of Thrombosis, Hemostasis (TSTH) Study Group
author_sort Shyh-Shin Chiou
collection DOAJ
description Abstract Background Hemophilia A (HA) treatment strategies aim to manage bleeding episodes and improve patients' quality of life. This study investigates the effectiveness of a preventative approach using intermediate-dose prophylaxis with standard half-life FVIII products in reducing bleeding rates and enhancing the quality of life for patients with severe HA. Methods A 4-year prospective longitudinal study followed 35 patients with severe HA (without FVIII inhibitors) who transitioned from a reactive treatment approach to intermediate-dose prophylaxis in Taiwan from 2014 until 2018. The study tracked annual bleeding rates (ABR) and annual joint bleeding rates (AjBR) alongside associated costs and patient-reported quality-of-life measures. Results Prophylaxis significantly reduced both ABR and AjBR compared with the previous treatment. After one year, ABR and AjBR decreased by 76.9% and 72.5%, respectively, with further reductions to 91.0% and 90.8% after 4 years (p < 0.001). While the average annual cost of factor VIII concentrate increased by 41.0% in the first year, the incremental cost-effectiveness ratio demonstrated ongoing benefits from ABR avoidance over the 4 years. Additionally, patients reported significant improvements in quality-of-life measures following the switch to prophylaxis (p = 0.036). Conclusion Intermediate-dose prophylaxis effectively reduced bleeding rates and improved quality of life in patients with severe HA. Despite initial cost increases, the intervention became cost effective over time. This study provides valuable data for healthcare policymakers, highlighting the long-term benefits of prophylaxis as a preventative approach for managing bleeding and improving overall well-being in patients with severe HA.
format Article
id doaj-art-d6c6a09186a74b0b9a50273f890ba8f3
institution Kabale University
issn 2199-1154
2198-9788
language English
publishDate 2024-11-01
publisher Adis, Springer Healthcare
record_format Article
series Drugs - Real World Outcomes
spelling doaj-art-d6c6a09186a74b0b9a50273f890ba8f32024-12-01T12:46:55ZengAdis, Springer HealthcareDrugs - Real World Outcomes2199-11542198-97882024-11-0111471172310.1007/s40801-024-00452-zEvaluating the Effectiveness of Prophylactic Strategies for Hemophilia A Management: A Real-World, Longitudinal Observational StudyShyh-Shin Chiou0Ching-Yeh Lin1Te-Fu Weng2Jiaan-Der Wang3Sheng-Chieh Chou4Ching-Tien Peng5Pei-Chin Lin6Yu-Mei Liao7Leanne Lai8Ming-Ching Shen9Taiwan Society of Thrombosis, Hemostasis (TSTH) Study GroupTaiwan Society of Thrombosis and Hemostasis (TSTH) Study GroupTaiwan Society of Thrombosis and Hemostasis (TSTH) Study GroupTaiwan Society of Thrombosis and Hemostasis (TSTH) Study GroupTaiwan Society of Thrombosis and Hemostasis (TSTH) Study GroupTaiwan Society of Thrombosis and Hemostasis (TSTH) Study GroupTaiwan Society of Thrombosis and Hemostasis (TSTH) Study GroupDivision of Pediatric Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University HospitalDivision of Pediatric Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University HospitalCollege of Pharmacy, Kaohsiung Medical UniversityTaiwan Society of Thrombosis and Hemostasis (TSTH) Study GroupAbstract Background Hemophilia A (HA) treatment strategies aim to manage bleeding episodes and improve patients' quality of life. This study investigates the effectiveness of a preventative approach using intermediate-dose prophylaxis with standard half-life FVIII products in reducing bleeding rates and enhancing the quality of life for patients with severe HA. Methods A 4-year prospective longitudinal study followed 35 patients with severe HA (without FVIII inhibitors) who transitioned from a reactive treatment approach to intermediate-dose prophylaxis in Taiwan from 2014 until 2018. The study tracked annual bleeding rates (ABR) and annual joint bleeding rates (AjBR) alongside associated costs and patient-reported quality-of-life measures. Results Prophylaxis significantly reduced both ABR and AjBR compared with the previous treatment. After one year, ABR and AjBR decreased by 76.9% and 72.5%, respectively, with further reductions to 91.0% and 90.8% after 4 years (p < 0.001). While the average annual cost of factor VIII concentrate increased by 41.0% in the first year, the incremental cost-effectiveness ratio demonstrated ongoing benefits from ABR avoidance over the 4 years. Additionally, patients reported significant improvements in quality-of-life measures following the switch to prophylaxis (p = 0.036). Conclusion Intermediate-dose prophylaxis effectively reduced bleeding rates and improved quality of life in patients with severe HA. Despite initial cost increases, the intervention became cost effective over time. This study provides valuable data for healthcare policymakers, highlighting the long-term benefits of prophylaxis as a preventative approach for managing bleeding and improving overall well-being in patients with severe HA.https://doi.org/10.1007/s40801-024-00452-z
spellingShingle Shyh-Shin Chiou
Ching-Yeh Lin
Te-Fu Weng
Jiaan-Der Wang
Sheng-Chieh Chou
Ching-Tien Peng
Pei-Chin Lin
Yu-Mei Liao
Leanne Lai
Ming-Ching Shen
Taiwan Society of Thrombosis, Hemostasis (TSTH) Study Group
Evaluating the Effectiveness of Prophylactic Strategies for Hemophilia A Management: A Real-World, Longitudinal Observational Study
Drugs - Real World Outcomes
title Evaluating the Effectiveness of Prophylactic Strategies for Hemophilia A Management: A Real-World, Longitudinal Observational Study
title_full Evaluating the Effectiveness of Prophylactic Strategies for Hemophilia A Management: A Real-World, Longitudinal Observational Study
title_fullStr Evaluating the Effectiveness of Prophylactic Strategies for Hemophilia A Management: A Real-World, Longitudinal Observational Study
title_full_unstemmed Evaluating the Effectiveness of Prophylactic Strategies for Hemophilia A Management: A Real-World, Longitudinal Observational Study
title_short Evaluating the Effectiveness of Prophylactic Strategies for Hemophilia A Management: A Real-World, Longitudinal Observational Study
title_sort evaluating the effectiveness of prophylactic strategies for hemophilia a management a real world longitudinal observational study
url https://doi.org/10.1007/s40801-024-00452-z
work_keys_str_mv AT shyhshinchiou evaluatingtheeffectivenessofprophylacticstrategiesforhemophiliaamanagementarealworldlongitudinalobservationalstudy
AT chingyehlin evaluatingtheeffectivenessofprophylacticstrategiesforhemophiliaamanagementarealworldlongitudinalobservationalstudy
AT tefuweng evaluatingtheeffectivenessofprophylacticstrategiesforhemophiliaamanagementarealworldlongitudinalobservationalstudy
AT jiaanderwang evaluatingtheeffectivenessofprophylacticstrategiesforhemophiliaamanagementarealworldlongitudinalobservationalstudy
AT shengchiehchou evaluatingtheeffectivenessofprophylacticstrategiesforhemophiliaamanagementarealworldlongitudinalobservationalstudy
AT chingtienpeng evaluatingtheeffectivenessofprophylacticstrategiesforhemophiliaamanagementarealworldlongitudinalobservationalstudy
AT peichinlin evaluatingtheeffectivenessofprophylacticstrategiesforhemophiliaamanagementarealworldlongitudinalobservationalstudy
AT yumeiliao evaluatingtheeffectivenessofprophylacticstrategiesforhemophiliaamanagementarealworldlongitudinalobservationalstudy
AT leannelai evaluatingtheeffectivenessofprophylacticstrategiesforhemophiliaamanagementarealworldlongitudinalobservationalstudy
AT mingchingshen evaluatingtheeffectivenessofprophylacticstrategiesforhemophiliaamanagementarealworldlongitudinalobservationalstudy
AT taiwansocietyofthrombosishemostasiststhstudygroup evaluatingtheeffectivenessofprophylacticstrategiesforhemophiliaamanagementarealworldlongitudinalobservationalstudy