Publication

Perioperative replacement therapy in haemophilia B: An appeal to "B" more precise

Opti-Clot Study Grp, Jul-2018, In : Haemophilia. 24, 4, p. 611-618 8 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Opti-Clot Study Grp (2018). Perioperative replacement therapy in haemophilia B: An appeal to "B" more precise. Haemophilia, 24(4), 611-618. https://doi.org/10.1111/hae.13469

Author

Opti-Clot Study Grp. / Perioperative replacement therapy in haemophilia B : An appeal to "B" more precise. In: Haemophilia. 2018 ; Vol. 24, No. 4. pp. 611-618.

Harvard

Opti-Clot Study Grp 2018, 'Perioperative replacement therapy in haemophilia B: An appeal to "B" more precise', Haemophilia, vol. 24, no. 4, pp. 611-618. https://doi.org/10.1111/hae.13469

Standard

Perioperative replacement therapy in haemophilia B : An appeal to "B" more precise. / Opti-Clot Study Grp.

In: Haemophilia, Vol. 24, No. 4, 07.2018, p. 611-618.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Opti-Clot Study Grp. Perioperative replacement therapy in haemophilia B: An appeal to "B" more precise. Haemophilia. 2018 Jul;24(4):611-618. https://doi.org/10.1111/hae.13469


BibTeX

@article{d4cb9db96ca547c6a7d77ac6109ac566,
title = "Perioperative replacement therapy in haemophilia B: An appeal to {"}B{"} more precise",
abstract = "IntroductionHaemophilia B is caused by a deficiency of coagulation factor IX (FIX) and characterized by bleeding in muscles and joints. In the perioperative setting, patients are treated with FIX replacement therapy to secure haemostasis. Targeting of specified FIX levels is challenging and requires frequent monitoring and adjustment of therapy.AimTo evaluate perioperative management in haemophilia B, including monitoring of FIX infusions and observed FIX levels, whereby predictors of low and high FIX levels were assessed.MethodsIn this international multicentre study, haemophilia B patients with FIXResultsA total of 255 surgical procedures were performed in 118 patients (median age 40 years, median body weight 79kg). Sixty percent of FIX levels within 24hours of surgery were below target with a median difference of 0.22 IUmL(-1) [IQR 0.12-0.36]; while >6days after surgery, 59{\%} of FIX levels were above target with a median difference of 0.19 IUmL(-1) [IQR 0.10-0.39]. Clinically relevant bleeding complications (necessity of a second surgical intervention or red blood cell transfusion) occurred in 7 procedures (2.7{\%}).ConclusionThis study demonstrates that targeting of FIX levels in the perioperative setting is complex and suboptimal, but although this bleeding is minimal. Alternative dosing strategies taking patient and surgical characteristics as well as pharmacokinetic principles into account may help to optimize and individualize treatment.",
keywords = "clotting factor concentrates, haemophilia B, haemostasis, individualized treatment, perioperative replacement therapy, surgical procedures, RECOMBINANT FACTOR-IX, FACTOR-VIII, A PATIENTS, PHARMACOKINETICS, PROPHYLAXIS, SURGERY, PATIENT, RISK, AGE",
author = "{Opti-Clot Study Grp} and Hazendonk, {H. C. A. M.} and T. Preijers and R. Liesner and P. Chowdary and D. Hart and D. Keeling and Driessens, {M. H. E.} and {Laros-van Gorkom}, {B. A. P.} and {van der Meer}, {F. J. M.} and K. Meijer and K. Fijnvandraat and Leebeek, {F. W. G.} and Mathot, {R. A. A.} and Collins, {P. W.} and Cnossen, {M. H.}",
year = "2018",
month = "7",
doi = "10.1111/hae.13469",
language = "English",
volume = "24",
pages = "611--618",
journal = "Haemophilia",
issn = "1351-8216",
publisher = "Wiley",
number = "4",

}

RIS

TY - JOUR

T1 - Perioperative replacement therapy in haemophilia B

T2 - An appeal to "B" more precise

AU - Opti-Clot Study Grp

AU - Hazendonk, H. C. A. M.

AU - Preijers, T.

AU - Liesner, R.

AU - Chowdary, P.

AU - Hart, D.

AU - Keeling, D.

AU - Driessens, M. H. E.

AU - Laros-van Gorkom, B. A. P.

AU - van der Meer, F. J. M.

AU - Meijer, K.

AU - Fijnvandraat, K.

AU - Leebeek, F. W. G.

AU - Mathot, R. A. A.

AU - Collins, P. W.

AU - Cnossen, M. H.

PY - 2018/7

Y1 - 2018/7

N2 - IntroductionHaemophilia B is caused by a deficiency of coagulation factor IX (FIX) and characterized by bleeding in muscles and joints. In the perioperative setting, patients are treated with FIX replacement therapy to secure haemostasis. Targeting of specified FIX levels is challenging and requires frequent monitoring and adjustment of therapy.AimTo evaluate perioperative management in haemophilia B, including monitoring of FIX infusions and observed FIX levels, whereby predictors of low and high FIX levels were assessed.MethodsIn this international multicentre study, haemophilia B patients with FIXResultsA total of 255 surgical procedures were performed in 118 patients (median age 40 years, median body weight 79kg). Sixty percent of FIX levels within 24hours of surgery were below target with a median difference of 0.22 IUmL(-1) [IQR 0.12-0.36]; while >6days after surgery, 59% of FIX levels were above target with a median difference of 0.19 IUmL(-1) [IQR 0.10-0.39]. Clinically relevant bleeding complications (necessity of a second surgical intervention or red blood cell transfusion) occurred in 7 procedures (2.7%).ConclusionThis study demonstrates that targeting of FIX levels in the perioperative setting is complex and suboptimal, but although this bleeding is minimal. Alternative dosing strategies taking patient and surgical characteristics as well as pharmacokinetic principles into account may help to optimize and individualize treatment.

AB - IntroductionHaemophilia B is caused by a deficiency of coagulation factor IX (FIX) and characterized by bleeding in muscles and joints. In the perioperative setting, patients are treated with FIX replacement therapy to secure haemostasis. Targeting of specified FIX levels is challenging and requires frequent monitoring and adjustment of therapy.AimTo evaluate perioperative management in haemophilia B, including monitoring of FIX infusions and observed FIX levels, whereby predictors of low and high FIX levels were assessed.MethodsIn this international multicentre study, haemophilia B patients with FIXResultsA total of 255 surgical procedures were performed in 118 patients (median age 40 years, median body weight 79kg). Sixty percent of FIX levels within 24hours of surgery were below target with a median difference of 0.22 IUmL(-1) [IQR 0.12-0.36]; while >6days after surgery, 59% of FIX levels were above target with a median difference of 0.19 IUmL(-1) [IQR 0.10-0.39]. Clinically relevant bleeding complications (necessity of a second surgical intervention or red blood cell transfusion) occurred in 7 procedures (2.7%).ConclusionThis study demonstrates that targeting of FIX levels in the perioperative setting is complex and suboptimal, but although this bleeding is minimal. Alternative dosing strategies taking patient and surgical characteristics as well as pharmacokinetic principles into account may help to optimize and individualize treatment.

KW - clotting factor concentrates

KW - haemophilia B

KW - haemostasis

KW - individualized treatment

KW - perioperative replacement therapy

KW - surgical procedures

KW - RECOMBINANT FACTOR-IX

KW - FACTOR-VIII

KW - A PATIENTS

KW - PHARMACOKINETICS

KW - PROPHYLAXIS

KW - SURGERY

KW - PATIENT

KW - RISK

KW - AGE

U2 - 10.1111/hae.13469

DO - 10.1111/hae.13469

M3 - Article

VL - 24

SP - 611

EP - 618

JO - Haemophilia

JF - Haemophilia

SN - 1351-8216

IS - 4

ER -

ID: 75526206