Moving towards Normalization of haemostasis and health equity: Evolving treatment goals for haemophilia A

Author:

Holme Pål André1,Blatný Jan23,Chowdary Pratima4ORCID,Lassila Riitta5ORCID,O'Connell Niamh6,Hermans Cédric7,Álvarez Román María Teresa8ORCID,Négrier Claude9ORCID,Coppola Antonio10ORCID,Oldenburg Johannes11ORCID

Affiliation:

1. Department of Haematology Oslo University Hospital and Institute of Clinical Medicine University of Oslo Oslo Norway

2. Hospital Bory Bratislava Slovakia

3. Masaryk University Brno Czech Republic

4. Katharine Dormandy Haemophilia and Thrombosis Centre Royal Free London London UK

5. Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Research Program Unit in Systems Oncology University of Helsinki Helsinki Finland

6. National Coagulation Centre St James's Hospital, Dublin, Ireland and Trinity College Dublin Dublin Ireland

7. Haemostasis and Thrombosis Unit, Division of Haematology Cliniques universitaires Saint‐Luc, Catholic University of Louvain (UCLouvain) Louvain Belgium

8. Department of Hematology La Paz University Hospital‐IdiPaz, Autonomous University Madrid Spain

9. UR4609 Hémostase & Thrombose University Lyon 1 Lyon France

10. Regional Reference Centre for Inherited Bleeding Disorders University Hospital of Parma Parma Italy

11. Institute of Experimental Hematology and Transfusion Medicine University Hospital Bonn, Medical Faculty, University of Bonn Bonn Germany

Abstract

AbstractBackgroundTreatment options for people with haemophilia are evolving at a rapid pace and a range of prophylactic treatment options using various technologies are currently available, each with their own distinct safety and efficacy profile.Treatment goalsThe access to replacement therapy and prophylaxis has driven a dramatic reduction in mortality and resultant increase in life expectancy. Beyond this, the abolition of bleeds and preservation of joint health represent the expected, but rarely attained, goals of haemophilia treatment and care. These outcomes also do not address the complexity of health‐related quality of life impacted by haemophilia and its treatment.ConclusionCapitalizing on the major potential of therapeutic innovations, ‘Normalization’ of haemostasis, as a concept, should include the aspiration of enabling individuals to live as normal a life as possible, free from haemophilia‐imposed limitations. To achieve this—being supported by the data reviewed in this manuscript—the concept of haemostatic and life Normalization needs to be explored and debated within the wider multidisciplinary teams and haemophilia community.

Funder

Swedish Orphan Biovitrum

Publisher

Wiley

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