Clinicians are generally comfortable with using extended half-life factor products in patients with hemophilia for the same indications as those for standard half-life concentrates, including nonsevere hemophilia and previously untreated patients. This is according to a national survey of hemophilia providers from hemophilia treatment centers in the United States. 

The results of the survey also showed that clinicians were more willing to switch patients with hemophilia B to extended half-life factor products for prophylaxis than patients with hemophilia A.

Concerns about the efficacy of extended half-life factor products in managing acute bleeding diatheses were primarily related to recombinant factor IX concentrates. 


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Finally, for major surgery, clinicians preferred standard half-life concentrates over extended half-life factor products.

Extended half-life factor products reduce the treatment burden in patients with hemophilia, as they reduce the infusion frequency needed. They, therefore, improve therapy adherence and quality of life. However, research has shown that some patients with hemophilia B experienced breakthrough bleeding with prophylaxis and suboptimal bleed control with extended half-life factor IX products.

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The aim of the present study was to gain more insight into the real-life experiences of clinicians with extended half-life factor products.

“Our goal was to examine the clinician perceptions about the efficacy of [extended half-life factor products] in [persons with hemophilia], specifically for managing acute bleeding diatheses and surgeries,” the authors wrote.

The findings presented here are based on the responses of 70 providers from 149 hemophilia treatment centers, the majority of whom were pediatric hematologists and had more than 10 years of practice experience.

The authors concluded that real-world comparative effectiveness studies through the American Thrombosis and Hemostasis Network will help clarify the current questions about the efficacy of extended half-life factor products in managing acute bleeding. 

“It remains to be seen if [extended half-life factor products] will survive the ‘test of time’ within the changing landscape of hemophilia treatment that includes access to promising nonfactor therapies and gene therapy,” they wrote.

Reference

Swaminathan N, Salinas-Luna V, Acharya S, Sharathkumar A. Perceptions about the efficacy of extended half-life (EHL) factor products in persons with haemophilia (PWH): a national survey of haemophilia providers from haemophilia treatment centres (HTCs) in the United States. Haemophilia. Published online September 30, 2021. doi:10.1111/hae.14427