Prophylaxis use among males with haemophilia B in the United States

• Published in: Haemophilia : the official journal of the World Federation of Hemophilia Vol. 23; no. 6; pp. 910 - 917
• Main Authors: Ullman, M., Zhang, Q. C., Grosse, S. D., Recht, M., Soucie, J. M.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.11.2017
• Subjects: Adolescent; Adult; Aged; BMI; Body mass index; Centers for Disease Control and Prevention, U.S. - statistics & numerical data; Child; Child, Preschool; Children; Data processing; ethnicity; Factor IX - therapeutic use; Factor IX deficiency; haemophilia B; Hemophilia; Hemophilia B - drug therapy; Hemophilia B - epidemiology; Hemorrhage - prevention & control; Humans; Male; Middle Aged; Minority & ethnic groups; obesity; overweight; Prevalence; Prophylaxis; United States - epidemiology; Young Adult; United States; haemophilia B; ethnicity; overweight; prophylaxis; obesity; BMI
• ISSN: 1351-8216; 1365-2516; 1365-2516
• DOI: 10.1111/hae.13317

Introduction Prophylaxis is considered the optimal treatment for persons with moderate to severe haemophilia (factor activity between 1‐5% of normal and <1% of normal respectively) in countries where safe factor concentrates are available and economically feasible. Historically, prophylactic treatment has not been well studied in the haemophilia B (HB) population due to difficulties in obtaining a sufficiently large sample. Aim This study examines the prevalence of prophylaxis use among a robust sample of persons with HB in the United States and its association with specific demographic and clinical characteristics. Methods Using data collected between 1998 and 2011 for the Centers for Disease Control and Prevention's Universal Data Collection project, we analysed data on 2428 males with moderate to severe HB aged 2‐79 years who were seen at 135 federally funded haemophilia treatment centres. Results Prevalence of prophylactic treatment in our sample was 35% among children and youth (ages 2‐19) and 14% among adults (age 20 and older). Increased HB prophylaxis use was significantly associated with younger age (<40 years), Hispanic ethnicity, severe disease and self‐infusion, while decreased use was associated with above‐normal body mass index (BMI) in adults. Health care coverage was vital, although type of coverage did not appear to influence access. Conclusions Our analysis confirms previous reports of lower prevalence of prophylaxis use among individuals with HB compared to those with haemophilia A and adds to the body of knowledge regarding treatment patterns among a historically understudied population.