A clinical case of arthroplasty in a patient with hemophilia under therapy with efmoroctocog alfa: 615.273.52:616.72-007.248

Abstract

Summary. The main haemophilia manifestations are hemorrhages in the joints that lead to haemophiliac arthropathy and subsequent severe disability. Prophylactic hemostatic therapy with factor VIII (FVIII) is used to prevent bleedings. The quality of life and life time of haemophilia patients have improved considerably. However, despite the current potentialities of haemostatic therapy, many unresolved problems remain. Only 37% of patients have no hemorrhages, and about 50% of patients have more than 2 bleeding cases per year. Primarily it is because the half-life of FVIII and the time of reaching its minimum residual activity can vary greatly in patients with the same disease form. In addition, patients have poor adherence to therapy due to the need for frequent intravenous FVIII administration and difficult vascular access. This led to the development of medication with prolonged action and alternative routes of administration. Efmoroctocog alfa, a recombinant clotting FVIII with deleted B-domain covalently linked to the Fc-domain of human immunoglobulin is one of these drugs. Due to the increased half-life of efmoroctocog alfa, in 99% of patients receiving this drug, became possible to reduce the number of infusions, the median annual incidence of all bleedings was reduced to 0–2 and spontaneous hemarthrosis were reduced to 0. Efmoroctocog alfa approved itself, demonstrating efficacy and safety in surgical interventions. In our country, efmoroctocog has been used for the first time at a major orthopaedic surgery in a patient with severe haemophilia. Efmoroctocog alfa provided effective hemostasis both during surgery and in the postoperative period and reduced the total drug intake.

For citation: Zorenko V. Yu., Polyanskaya T. Yu., Sadykova N.V., Karpov E.E. A clinical case of arthroplasty in a patient with hemophilia under therapy with efmoroctocog alfa. Tromboz, gemostaz i reologiya. 2022;(4):85–92. (In Russ.).

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