Prophylaxis

Joint Outcome Study

The Joint Outcome Study, a landmark study supporting prophylaxis in the treatment of haemophilia
 

  • Until recently there has been limited evidence from prospective randomised trials to support the use of prophylaxis in the treatment of haemophilia
  • The ‘Joint Outcome Study' is a prospective, randomised, clinical trial that provides convincing evidence in support of prophylaxis with KOGENATE® Bayer in the treatment of haemophilia 23
  • Results demonstrated that prophylaxis patients had fewer joint bleeds per year and reduced joint damage compared to on-demand patients 23

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on the Joint Outcome Study

 

UKHCDO recommendations

“Prophylaxis is the administration of clotting factors at regular intervals to prevent bleeding and must be the goal of all hemophilia care programmes until a cure is available.” 10

Prophylactic treatment should be offered to all severely haemophilic boys so that:

  • Recently diagnosed haemophilic boys will be protected from long term joint damage and arthropathy 24
  • In older haemophilic boys, further joint damage is prevented 24

The World Federation of Hemophilia (WFH) recommendations

  • Prophylaxis has been shown to decrease joint bleeding, preserve joint function and thus improve quality of life 10
  • The most commonly suggested protocol for prophylaxis is the infusion of 25-40iu/kg of clotting factor concentrates three times a week for those with haemophilia A, and twice a week for those with haemophilia B 10
  • Prophylaxis is cost-effective in the long-term because it eliminates the high cost associated with subsequent management of damaged joints 10

 

JOINT OUTCOME STUDY

Landmark Study Demonstrates Benefits of Early Prophylactic Use of Recombinant Factor VIII

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References

10. World Federation of Hemophilia, Guidelines for the Management of Hemophilia, 2005
23. Manco-Johnson MJ et al. N Engl J Med 2007;357:535-544
24. UKHCDO Prophylaxis in the treatment of haemophilic boys 1004;AGM, Appendix(vi)

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Date of preparation: December 2010 UK.PH.HN.KOG.2010.250.28.3