Comparison of effect of Prophylaxis Therapy and On Demand Therapy on Joint Bleeding Episodes in Children With Hemophilia in Moewardi Hospital, Surakarta

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Asia Pacific Journal of Paediatri Child Health, Volume 4, Apr - Jun 2021

Comparison of effect of Prophylaxis Therapy and On Demand Therapy on Joint Bleeding Episodes in Children With Hemophilia in Moewardi Hospital, Surakarta

Dhimas Naufal 1 , Muhammad Riza 1 , Yulidar Hafidh 1

ABSTRACT

Background: Factor replacement therapy is the primary treatment in children with hemophilia. Factor replacement is classified into two categories, prophylactic treatment and on-demand treatment. The administration of these two therapies may vary in any hemophilia center based on the availability and stakeholder policies.

Aim: This study compares characteristics and analyses groups of children with hemophilia treated prophylactically and those who received on-demand therapy.

Methods: All children with hemophilia registered in Dr. Moewardi Hospital were included in this study. All subjects were provided information about prophylaxis treatment. The prophylactic group received a factor replacement therapy of 10-15 IU/kg/time; for patients with hemophilia A given three times a week and patients with hemophilia B given twice a week. The number of bleeding events and joint bleeding in 6 months was recorded. In addition, inhibitor testing was carried out in both groups. Subjects were observed for six months.

Results: In this study, it was noted that there were significant differences between the prophylactic group and the on-demand treatment group in terms of the number of joints affected and the frequency of bleeding. In the prophylactic group, the tendency for the number of joints to be involved was found in 2 locations, whereas those who did not receive prophylaxis had one joint involvement, with p = 0.022 (p <0.05). The prophylactic group's frequency averaged 16.00 +6.20 per year, while those who did not receive prophylaxis averaged a bleeding frequency of 24.28 +10.57 with p = 0.048 (p <0.05). There was no significant correlation between the frequency of bleeding with the subject's BMI (p = 0.195) and the severity of hemophilia (p = 0.823). This study also found a correlation between the number of affected joints with age, where the younger the age, the more joints' location were affected with p = 0.042 (p <0.05).

Conclusion: Prophylactic therapy was effective in reducing joint bleeding episodes and bleeding frequency in children with hemophilia.

Keywords: Children, hemophilia, prophylaxis vs. on-demand treatment

Author’s Affiliation: 1- Department of Child Health, Faculty of Medicine, Sebelas Maret University/ Dr. Moewardi Hospital, Surakarta, Indonesia

Correspondence: Dhimas Naufal, Email: dhimasnaufalmd@gmail.com