Hemophilia Treatment

Hemophilia treatment is carried out under the supervision of hematology specialists, and various treatment centers are available for this condition. These centers consist of specialized teams of doctors, nurses, physiotherapists, and psychologists who provide care and treatment for people with bleeding disorders.
Treatment Plan
Each person with hemophilia has an individual treatment plan, which is regularly reviewed in consultation with a hematologist or hemophilia nurses. This plan includes preventive therapies as well as treatment interventions in case of injury or surgery.
Types of Treatments
Replacement Factor Therapy
Treating hemophilia with replacement clotting factors is one of the most common methods. This therapy is performed through intravenous injections of clotting factors. In some cases, special devices are used for easier administration.
Replacement factor therapy is usually given preventively to avoid bleeding caused by injury or surgery. Depending on the patient’s condition, it can be administered regularly—ranging from daily to once every two weeks.
Non-Factor Therapies
In addition to factor replacement therapy, non-factor treatments are also used to prevent bleeding. These therapies do not replace clotting factors but instead help the body control bleeding through other mechanisms. They are usually given as subcutaneous injections.
Desmopressin (DDAVP)
Desmopressin is a synthetic hormone that helps the body release stored factor VIII into the bloodstream, aiding the clotting process. This treatment is used for some patients with mild hemophilia A and for some women with bleeding disorders. Desmopressin can be administered intravenously, subcutaneously, or, in some cases, as a nasal spray.
Gene Therapy
Gene therapy for hemophilia is currently in clinical trial stages and is not yet widely used in many countries. This treatment involves inserting a copy of the factor VIII or IX gene into the patient’s body so that they can naturally produce these clotting factors. Early results from this therapy have been promising.
Methods of Treatment and Bleeding Management in Hemophilia Patients: Medications, Physiotherapy, and Special Care
Tranexamic Acid
This medication slows down the breakdown of blood clots after they form and is used to treat bleeding in the mouth, nose, gastrointestinal tract, and after dental surgeries.
Hormonal Therapy
Hormone therapy may be useful for women with heavy menstrual bleeding. These drugs can raise factor VIII levels. Birth control pills and intrauterine devices (IUDs) such as Mirena and Kyleena are commonly used to control heavy menstrual bleeding.
Moderate and Severe Hemophilia
Treatments are used similarly to prevent bleeding, pain, and joint damage.
Mild Hemophilia
In most cases, people with mild hemophilia only need treatment if bleeding occurs, usually after injury or surgery.
Physiotherapy
Physiotherapy and therapeutic exercises, under the supervision of specialized physiotherapists, are used to prevent joint damage and improve the physical condition of hemophilia patients.
PRICER Principles
These principles include Protection, Rest, Ice, Compression, Elevation, and Rehabilitation, widely used in managing bleeding and joint injuries in hemophilia patients.
Resistance to Treatment (Inhibitors)
In some hemophilia patients, the body develops resistance to clotting factor therapy. Treatments such as bypassing agents and non-factor therapies are available to manage this complication.
Source:
Haemophilia Foundation Australia. (February 2024). Haemophilia booklet. Melbourne: Haemophilia Foundation Australia. Retrieved from: https://www.haemophilia.org.au/resources/publications/haemophilia/haemophilia-booklet
Compiled by: Sara Khoshnoud

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