DOI: 10.12890/2022_003343
Efficacy of Replacement and Anti-Platelet Therapies in a Patient with Severe Haemophilia A Undergoing Percutaneous Coronary Stent Implantation
Authors
d.cultrera@policlinico.unict.it
Keywords
Haemophilia A, personalized prophylaxis, pharmacokinetics, coronary stent, recombinant FVIII, Nuwiq®Abstract
Introduction: Severe haemophilia A is characterized by serious factor VIII deficiency (biological activity <1%) resulting in frequent spontaneous haemorrhage and abnormal bleeding after minor injury, surgery or tooth extraction.
Patient and Methods: We report the case of a 58-year-old patient with severe haemophilia A without inhibitors but with other comorbidities (HCV and HIV seroconversion), who underwent coronary angioplasty and stent implantation after acute myocardial infarction.
Results: Compared with previous therapy, Nuwiq® led to a reduction of about 20% in drug consumption (360,000 IU vs 540,000 IU per year) and in the annualized bleeding rate (ABR) (5 vs 15).
Discussion: Pharmacokinetic-guided personalized prophylaxis with Nuwiq® provided bleeding protection with good tolerability and a satisfactory pharmacokinetic profile in a patient with severe haemophilia A and comorbidities whose replacement therapy had to be adjusted because of other contraindicated treatment.
References
- Lissitchkov T, Rusen L, Georgiev P, Windyga J, Klamrothh R, Gercheva L, et al. PK-guided personalized prophylaxis with Nuwiq® (human-cl rhFVIII) in adults with severe hemophilia A. Haemophilia 2017;23:697–704.
