Self-therapy for haemophilia in Norway. Effect on transfusion frequency and days lost from work.

During the years 1975--77, 35 patients with haemophilia A or B (factor level of 1% or less) were instructed to administer concentrates of the deficient factor (mean dose 14 U/kg) i.v. in case of episodic, uncomplicated bleedings without prior consultation with a physician. At Dec. 1977, 33 of these patients (29 with haemophilia A, 4 with B) were taking part in the program. They represent 35% of all Norwegian patients above 7 years of age with severe haemophilia in whom high-titered antibodies have not been demonstrated. For 13 patients, records from 2 years on self-therapy have been compared with records from the last year before self-therapy. During the first year on self-therapy the number of days lost from work dropped by 77%, while the number of transfusions increased by 22%. During the second year, days lost from work were still low (68% decrease compared to the year preceding self-therapy) and the transfusion frequency remained unchanged. Significant side-effects of antihaemophilic concentrates were not observed and vein damage was not a problem. Joint motion studies did not indicate progress of haemophilic arthropathy during self-therapy. Properly supervised self-therapy is practical and safe and improves considerably to quality of life.