Prophylaxis (Primary and Secondary)

Primary Prophylaxis

There are two types of prophylaxis — primary and secondary. The use of primary prophylaxis has allowed many children with severe hemophilia to live more normal lives with fewer acute bleeding episodes and decreased orthopedic complications. When begun at an early age and continued in an uninterrupted fashion, primary prophylaxis has been useful in preventing hemophilic arthropathy.

Definition

Regularly scheduled treatments, administered 2 or 3 predetermined days of the week, starting at an early age (before frequent bleeds have occurred) to prevent bleeding

Goal

Prevent spontaneous joint bleeds , the development of joint disease and decrease the risk of other serious bleeding episodes

Advantages

  • Decreased number of bleeds in people with poor venous access
  • Decreased joint disease, prevent other serious bleeds
  • Minimize family lifestyle disruption

Disadvantages

  • Might require central venous access device
  • Expensive

Secondary Prophylaxis

Most HTCs also recommend secondary prophylaxis for some of their patients.

Definition

Factor infused on a regular schedule after a person has had several bleeds into a single joint (also called a target joint)

Goal

Prevent further bleeding into the joint and prevent joint disease

Advantages

Helps prevent bleeding into other joints

Secondary prophylaxis can also be used as a short-term treatment following a major hemorrhage. Its purpose is to allow the joint or muscle to heal, absorb the blood in that joint or muscle, and prevent further bleeding.