Administration and dosing schedules
|Factors to consider when designing prophylaxis protocol:|
Prophylaxis is the regular infusion of clotting factor concentrates in an attempt to raise clotting factor levels and to keep them at 1% or higher at all times. There are a number of ways to achieve this; however, how it is done varies both from country to country and even within the same country.
Studies are still underway to determine the best dosing schedule (also called a ‘protocol’). A prophylaxis schedule should outline:
- The type of factor product to be used
- The dose of factor administered with each injection
- The frequency at which treatment is administered
- The time (of day, or week) that treatment is administered
There are currently two protocols in use for which there is long-term data:
- The Malmö protocol: Injections of 25-40 IU/kg, administered three times a week for those with haemophilia A and twice a week for those with haemophilia B.
- The Utrecht protocol: Injections of 15-30 IU/kg, administered three times a week for those with haemophilia A and twice a week for those with haemophilia B.
While these are the protocols that have been studied most extensively, the ultimate protocol has not yet been defined. Wherever possible the protocol should be tailored to the patient’s individual needs and circumstances.