Hamostaseologie. 2022 Oct;42(S 01):S24-S31. doi: 10.1055/s-0042-1757552. Epub 2022 Oct 26.
Initial treatment in patients with haemophilia remains challenging. The choice of therapy, timing, dose and frequency have been and are still under intense debate. New treatment options like novel factor concentrates and non-factor therapies broaden the discussion.
The German Paediatric Haemophilia Research Database (GEPHARD) is a multicentre prospective observational study including children and adolescents with haemophilia A or B (FVIII or FIX levels <25 IU/dL) in a German treatment centre after January 1st, 2017. A cross-sectional analysis was performed in June 2021.
249 children and adolescents from 22 participating centres in Germany were analysed in this cross-sectional analysis. 203 patients suffered from haemophilia A (PwHA) and 46 from haemophilia B (PwHB). The median age at diagnosis for Pw severe HA or HB was 6 or 2 months, the median age at analysis was 33 or 35 months for Pw severe HA or B, respectively. 117 Pw severe HA received treatment, including plasma derived concentrates (n = 43), standard recombinant concentrates (n = 23), extended half live concentrates (n = 33) and non-replacement therapies (n = 18). For Pw severe HB, plasma derived concentrates (n = 3), standard recombinant concentrates (n = 8) and extended half live concentrates (n = 14) were used. Current inhibitors were reported in 16 PwHA and 1 PwHB.
GEPHARD was successfully established as a national cohort for newly diagnosed PwH in Germany. Epidemiological and treatment data were presented. Longitudinal analyses of this growing cohort will allow to value treatment strategies and their outcome in the evolving treatment landscape.
血友病患者的初始治疗仍然具有挑战性。治疗选择、时机、剂量和频率一直是且仍然是激烈争论的话题。新型治疗选择,如新型因子浓缩物和非因子治疗方法,拓宽了讨论范围。
德国儿科血友病研究数据库(GEPHARD)是一项多中心前瞻性观察研究,纳入了 2017 年 1 月 1 日后在德国治疗中心确诊的血友病 A 或 B 患儿和青少年(FVIII 或 FIX 水平 <25IU/dL)。于 2021 年 6 月进行了横断面分析。
在这项横断面分析中,对来自德国 22 个参与中心的 249 名儿童和青少年进行了分析。203 名患者患有血友病 A(PwHA),46 名患有血友病 B(PwHB)。PwHA 严重型或 HB 严重型诊断时的中位年龄分别为 6 或 2 个月,分析时的中位年龄分别为 33 或 35 个月。117 名 PwHA 严重型接受了治疗,包括血浆源性浓缩物(n=43)、标准重组浓缩物(n=23)、延长半衰期浓缩物(n=33)和非替代治疗(n=18)。对于 PwHB 严重型,使用了血浆源性浓缩物(n=3)、标准重组浓缩物(n=8)和延长半衰期浓缩物(n=14)。报告了 16 名 PwHA 和 1 名 PwHB 有当前抑制剂。
GEPHARD 成功建立为德国新诊断的 PwHA 的国家队列。呈现了流行病学和治疗数据。对这一不断增长的队列进行纵向分析,将有助于评估治疗策略及其在不断发展的治疗环境中的结果。