FEIBA prophylaxis case studies

FEIBA prophylaxis has been shown to provide significant benefits to haemophilia patients with inhibitors. Explore the real-life case studies outlined on this page to see the outcome of FEIBA prophylaxis. These cases are individual examples and may not be representative of all patients undergoing FEIBA prophylaxis therapy:

Haemophilia A case studies
Haemophilia B case study
Long-term (5 years) prophylaxis case study

Patient 1: Haemophilia A case study1

(Patient #2 out of a retrospective case series of 6)
Prophylaxis initiated at 24.1 years of age for 2.2 years

Pre-prophylaxis:

  • Persistent bleeding in knees and elbows and a major haemorrhage at surgical site
  • FEIBA prophylactic dose: 100 U/kg daily

After 2.2 years of prophylaxis:

  • 81% reduction in haemorrhages per year over the course of 2.2 years (from 39 bleeds to 6 bleeds)
  • After 4 years of ITI in conjunction with more than 2 years of FEIBA prophylaxis, patient became fully tolerised (with an inhibitor titre of less than 0.8 BU) and at the last evaluation was receiving prophylaxis with a FVIII concentrate

Patient 2: Haemophilia A case study2

(Patient #3 out of a retrospective case series of 5)
Inhibitor detected at age 24 months. Prophylaxis initiated at 10.5 years of age.

Pre-prophylaxis:

  • A total of 24 bleeds in 6 months; patient had reduced mobility in right knee
  • FEIBA prophylactic dose: 75 U/kg 3x/week (to treat acute traumatic haemarthroses during prophylaxis, dosage increased to 75 U/kg every 12 hours for 3 doses, followed by daily doses for at least two weeks or until return of joint function and muscle strength)

After 15 months of prophylaxis:

  • 87% mean reduction in bleeds per 6 months (14 fewer bleeds per year)
  • Improved orthoapedic status of right knee, with full flexion
  • Prophylaxis with FEIBA allowed patient to exercise without the occurrence of bleeding episodes, making aggressive physical therapy possible

Patient 3: Haemophilia B case study1

(Patient #6 out of a retrospective case series of 6)
Prophylaxis initiated at 8.8 years of age for 4.25 years

Pre-prophylaxis:

  • Hospitalised often and for extended periods with uncontrolled bleeding in his knee and in both elbows
  • FEIBA prophylactic dose: 100 U/kg daily or 50-75 U/kg every third day

After 4.25 years of prophylaxis:

  • 85% reduction in haemorrhages (bleeding episodes reduced from 113.0 to 16.47 per year)
  • Following rehabilitation, he was able to participate in physical activity such as basketball
  • No hospitalisation or emergency department visits
  • Improvement in mobility (<5 days missed per school year)

Patient 4: Long-term (five years) prophylaxis case study3

(Patient #4 out of a retrospective case series of 7)
Long-term FEIBA prophylaxis initiated at 6 years of age for 36 months in a hard-to-treat patient with preexisting orthopaedic damage

Pre-long-term prophylaxis:

  • Bleeding episodes were not well controlled (i.e., patient had limited movement and could not walk)
  • FEIBA prophylactic dose: 50-100 U/kg daily

After 5 years of prophylaxis:

  • Both of the patient's knees improved; following this, he was able to walk
  • (Patient later went on to develop a new target joint in the right ankle and arthropathy progressed in his right knee with synovitis)

References

  1. 1. Valentino LA. The benefits of prophylactic treatment with APCC in patients with haemophilia and high-titre inhibitors: a retrospective case series. Haemophilia. 2009: 15:733-742.
  2. 2. Leissinger CA, Becton DL, Ewing NP, Valentino LA. Prophylactic treatment with activated prothrombin complex concentrate (FEIBA) reduces the frequency of bleeding episodes in paediatric patients with haemophilia A and inhibitors. Haemophilia. 2007:1-7.
  3. 3. Hilgartner MW, Makipernaa A, DiMichele DM. Long-term FEIBA prophylaxis does not prevent progression of existing joint disease. Haemophilia. 2003:9:261-268.

Publications

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Sustained activity

FEIBA offers a long dosing interval. Read more

Publications

Access articles related to managing haemophilia patients with inhibitors. Read more

Dosing FEIBA

Learn how to dose FEIBA. Read more

Effective prophylaxis

Learn how FEIBA prophylaxis can reduce bleed frequency and preserve joints. Read more