Hemophilia, a blood clotting disorder, is a serious inherited disease affecting mostly males. Hemophilia requires lifelong management and continuing treatment to prevent spontaneous bleeding, or bleeding after injury or surgery. People with hemophilia A, the most common type affecting 80 percent of people with hemophilia, lack the normal amount of Factor VIII, a protein that helps blood clot. Treatment for hemophilia A centers on replacing the missing protein or increasing the body's Factor VIII output to stop or prevent bleeding.
Features
Several types of medication are used to treat hemophilia A. Clotting factor made from human blood that's been treated to prevent transmission of viruses such as hepatitis B and C, and human immunodeficiency virus (HIV), or laboratory reproduced clotting factor are used to replace the missing clotting factor. Factor VIII is easily administered at home over a 15-minute period, according to the National Heart Lung and Blood Institute. Mild cases of hemophilia A may be treated with desmopressin, or DDAVP, which stimulates the body to release more Factor VIII, the Mayo Clinic explains. DDAVP is given via injection or as a nasal spray.
Prevention/Solution
Treatment with Factor VIII can be done representatively, on a regular schedule, or on a demand basis, when bleeding starts. Demand therapy is less expensive but may result in more severe bleeding episodes, since bleeding inside the body may occur before symptoms occur. Preventative or prophylactic treatments may decrease bleeding into joints which can seriously damage them.
Goals
Factor VIII infusions augment low levels of clotting factor in the blood. To keep blood clotting normally requires clotting factor levels of 30 percent or more. Most people with hemophilia have 5 percent of the normal levels, and people with severe hemophilia have less than 1 percent of normal levels. Drugs like DDAVP aren't used for people with severe hemophilia because they can't raise the Factor VIII levels enough to stop bleeding.
Infusing Factor VIII raises the blood levels temporarily; the goal is to raise levels to 30 percent of normal after dental work or an incipient joint bleed, to 50 percent if a joint bleed is active, and to 100 percent before surgery, states Merck. To achieve a higher percentage requires more infusions.
Benefits
Factor VIII and DDAVP treatment help hemophiliacs live a more normal life with less permanent joint damage. Since the drugs are readily available, patients can be treated at home or while on vacation, reducing hospital stays and emergency room visits.
Complications
Antibodies to Factor VIII called inhibitors develop in around 20 percent of patients after repeated exposure to the drugs, warns the National Heart Lung and Blood Institute. This serious development lessens the effectiveness of the treatment, requiring greater quantities of the drug. Viruses that cause serious disease such as HIV and hepatitis B and C can also be passed on through human Factor VIII. This was common before 2000, but no documented cases have occurred in the last 10 years. Recombinant Factor VIII eliminates these concerns.
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