PB0641 - The benefits of prophylaxis with low dose factor VIII in the treatment of severe haemophilia A in Limpopo, South Africa.

Background: In the management of haemophilia, the currently accepted standard of care is prophylaxis therapy. In South Africa, because of many challenges, episodic therapy is still widely being used alongside with prophylaxis. A comparative outcome between the two regimens in paediatric patients living with severe haemophilia A has not been previously studied in Limpopo, South Africa.

Aims: To describe and compare annualised bleeding rate and factor VIII consumption between participants on episodic and prophylactic treatment groups.

Methods: A retrospective chart review was conducted over a period of five years. Study participants included 18 on episodic treatment, 6 on prophylactic treatment and 2 on bimodal treatment, where either one of the two regimens was used at some time during the period of the study. Data was collected and captured onto Microsoft Excel and analysed using descriptive statistics and comparative data using STATA.

Results: Compared to the episodic group, participants in the prophylactic group had a substantial reduction in annualised bleeding rate with a median of 4 vs 6 but the annual median factor VIII consumption was higher (12000 vs 4000).

Conclusion(s): The study outlines an overview of the care of children with severe haemophilia A in Limpopo province (South Africa). Most importantly, the results show that low dose prophylaxis could be a better option to the traditional dose prophylaxis in low resource countries. The cost is higher, but the outcome is significantly better with reduced bleeding episodes.