Short-term oral corticosteroid therapy for acute haemarthrosis in haemophilia patients with high-titre inhibitors

Desiree Medeiros, J. A. Laufenberg, K. L. Miller, G. R. Buchanan

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Treatment of acute bleeding events is unsatisfactory in patients with haemophilia and high-titre factor VIII (FVIII) inhibitors. In order to determine whether short-term corticosteroid therapy enhances resolution of the signs and symptoms of acute haemarthrosis, we performed a randomized, double-blind, placebo-controlled study in children with FVIII deficiency and high-titre inhibitors receiving Factor Eight Inhibitor Bypass Activity (FEIBA®) for acute haemorrhagic events. At each haemarthrosis, patients were randomized to receive either prednisolone 2 mg kg-1 day-1 or placebo-divided t.i.d. for 2 days (six doses) in addition to FEIBA. The primary endpoint was the number of subsequent doses of FEIBA required. The effect of the study medication was also assessed subjectively by patients or parents, by physical examination and by repeated haemorrhages into the joint. During the study period, seven patients were enrolled with 45 evaluable events, 24 treated with prednisolone and 21 with placebo. An average of 2.08 and 1.86 doses of FEIBA were infused in the prednisolone- and placebo-treated patients, respectively. By Wilcoxon Rank Sum Test, there was no statistically significant difference in number of additional infusions of FEIBA or duration of symptoms between the corticosteroid and placebo arms. We conclude that there is no significant benefit of a 2-day course of oral corticosteroids as adjunctive therapy for haemarthrosis in patients with haemophilia and a high-titre inhibitor.

Original languageEnglish (US)
Pages (from-to)85-89
Number of pages5
JournalHaemophilia
Volume13
Issue number1
DOIs
StatePublished - Jan 2007

Fingerprint

Hemarthrosis
Hemophilia A
Adrenal Cortex Hormones
Placebos
Prednisolone
Nonparametric Statistics
Therapeutics
Hemorrhage
Factor VIII
Signs and Symptoms
Physical Examination
Joints
Parents

Keywords

  • Corticosteroids
  • FEIBA
  • Haemarthrosis
  • Haemophilia
  • High-titre inhibitor

ASJC Scopus subject areas

  • Hematology

Cite this

Short-term oral corticosteroid therapy for acute haemarthrosis in haemophilia patients with high-titre inhibitors. / Medeiros, Desiree; Laufenberg, J. A.; Miller, K. L.; Buchanan, G. R.

In: Haemophilia, Vol. 13, No. 1, 01.2007, p. 85-89.

Research output: Contribution to journalArticle

Medeiros, Desiree ; Laufenberg, J. A. ; Miller, K. L. ; Buchanan, G. R. / Short-term oral corticosteroid therapy for acute haemarthrosis in haemophilia patients with high-titre inhibitors. In: Haemophilia. 2007 ; Vol. 13, No. 1. pp. 85-89.
@article{11dc83837a1f42549f4fcc9b74556dfc,
title = "Short-term oral corticosteroid therapy for acute haemarthrosis in haemophilia patients with high-titre inhibitors",
abstract = "Treatment of acute bleeding events is unsatisfactory in patients with haemophilia and high-titre factor VIII (FVIII) inhibitors. In order to determine whether short-term corticosteroid therapy enhances resolution of the signs and symptoms of acute haemarthrosis, we performed a randomized, double-blind, placebo-controlled study in children with FVIII deficiency and high-titre inhibitors receiving Factor Eight Inhibitor Bypass Activity (FEIBA{\circledR}) for acute haemorrhagic events. At each haemarthrosis, patients were randomized to receive either prednisolone 2 mg kg-1 day-1 or placebo-divided t.i.d. for 2 days (six doses) in addition to FEIBA. The primary endpoint was the number of subsequent doses of FEIBA required. The effect of the study medication was also assessed subjectively by patients or parents, by physical examination and by repeated haemorrhages into the joint. During the study period, seven patients were enrolled with 45 evaluable events, 24 treated with prednisolone and 21 with placebo. An average of 2.08 and 1.86 doses of FEIBA were infused in the prednisolone- and placebo-treated patients, respectively. By Wilcoxon Rank Sum Test, there was no statistically significant difference in number of additional infusions of FEIBA or duration of symptoms between the corticosteroid and placebo arms. We conclude that there is no significant benefit of a 2-day course of oral corticosteroids as adjunctive therapy for haemarthrosis in patients with haemophilia and a high-titre inhibitor.",
keywords = "Corticosteroids, FEIBA, Haemarthrosis, Haemophilia, High-titre inhibitor",
author = "Desiree Medeiros and Laufenberg, {J. A.} and Miller, {K. L.} and Buchanan, {G. R.}",
year = "2007",
month = "1",
doi = "10.1111/j.1365-2516.2006.01410.x",
language = "English (US)",
volume = "13",
pages = "85--89",
journal = "Haemophilia",
issn = "1351-8216",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Short-term oral corticosteroid therapy for acute haemarthrosis in haemophilia patients with high-titre inhibitors

AU - Medeiros, Desiree

AU - Laufenberg, J. A.

AU - Miller, K. L.

AU - Buchanan, G. R.

PY - 2007/1

Y1 - 2007/1

N2 - Treatment of acute bleeding events is unsatisfactory in patients with haemophilia and high-titre factor VIII (FVIII) inhibitors. In order to determine whether short-term corticosteroid therapy enhances resolution of the signs and symptoms of acute haemarthrosis, we performed a randomized, double-blind, placebo-controlled study in children with FVIII deficiency and high-titre inhibitors receiving Factor Eight Inhibitor Bypass Activity (FEIBA®) for acute haemorrhagic events. At each haemarthrosis, patients were randomized to receive either prednisolone 2 mg kg-1 day-1 or placebo-divided t.i.d. for 2 days (six doses) in addition to FEIBA. The primary endpoint was the number of subsequent doses of FEIBA required. The effect of the study medication was also assessed subjectively by patients or parents, by physical examination and by repeated haemorrhages into the joint. During the study period, seven patients were enrolled with 45 evaluable events, 24 treated with prednisolone and 21 with placebo. An average of 2.08 and 1.86 doses of FEIBA were infused in the prednisolone- and placebo-treated patients, respectively. By Wilcoxon Rank Sum Test, there was no statistically significant difference in number of additional infusions of FEIBA or duration of symptoms between the corticosteroid and placebo arms. We conclude that there is no significant benefit of a 2-day course of oral corticosteroids as adjunctive therapy for haemarthrosis in patients with haemophilia and a high-titre inhibitor.

AB - Treatment of acute bleeding events is unsatisfactory in patients with haemophilia and high-titre factor VIII (FVIII) inhibitors. In order to determine whether short-term corticosteroid therapy enhances resolution of the signs and symptoms of acute haemarthrosis, we performed a randomized, double-blind, placebo-controlled study in children with FVIII deficiency and high-titre inhibitors receiving Factor Eight Inhibitor Bypass Activity (FEIBA®) for acute haemorrhagic events. At each haemarthrosis, patients were randomized to receive either prednisolone 2 mg kg-1 day-1 or placebo-divided t.i.d. for 2 days (six doses) in addition to FEIBA. The primary endpoint was the number of subsequent doses of FEIBA required. The effect of the study medication was also assessed subjectively by patients or parents, by physical examination and by repeated haemorrhages into the joint. During the study period, seven patients were enrolled with 45 evaluable events, 24 treated with prednisolone and 21 with placebo. An average of 2.08 and 1.86 doses of FEIBA were infused in the prednisolone- and placebo-treated patients, respectively. By Wilcoxon Rank Sum Test, there was no statistically significant difference in number of additional infusions of FEIBA or duration of symptoms between the corticosteroid and placebo arms. We conclude that there is no significant benefit of a 2-day course of oral corticosteroids as adjunctive therapy for haemarthrosis in patients with haemophilia and a high-titre inhibitor.

KW - Corticosteroids

KW - FEIBA

KW - Haemarthrosis

KW - Haemophilia

KW - High-titre inhibitor

UR - http://www.scopus.com/inward/record.url?scp=33845736947&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845736947&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2516.2006.01410.x

DO - 10.1111/j.1365-2516.2006.01410.x

M3 - Article

C2 - 17212730

AN - SCOPUS:33845736947

VL - 13

SP - 85

EP - 89

JO - Haemophilia

JF - Haemophilia

SN - 1351-8216

IS - 1

ER -