PB0524 - Burden of difficult venous access in patients with Hemophilia A - Results from DIVA real-world data research

Background: Hemophilia A (HA) is traditionally treated with intravenous FVIII mostly twice or thrice a week to prevent spontaneous bleeding. Difficult venous access (DVA) remains a significant challenge for successful prophylaxis in countries with limited availability of subcutaneous therapies such as emicizumab, while data on its prevalence are narrow.

Aims: This first non-interventional, multicentric, real-world-data study investigates DVA prevalence in HA and its impacts on disease burden.

Methods: Study executed via an e-survey, involved 130 patients with severe HA receiving only IV treatments. E-survey was completed by patients in 62.3% and by caregivers in 37.7%, recruited from 17 centres in Turkey and Bosnia-Herzegovina. DVA was defined as at least 2 failed IV attempts in a single administration in the last 3 months. All data were analyzed by descriptive statistics by an independent CRO.

Results: DVA occurred in 70.0% (n=91) of participants, with 52.7% (n=48) of them experiencing it 2–4 times and 26.4% (n=24) more than 4 times. DVA prevalence ranged from 50% to 78.2% among different age groups (Table 1). Self-administration ratio was 46.2% (n=60), caregiver-infusion 27.7% (n=36), healthcare professional’s (HCP’s) support 20.8% (n=27), combination of caregiver-infusion with self-administration or HCP’s support 5.3% (n=7). Highest DVA prevalence was in caregiver-administered subpopulation (77.8%). Participants claimed that prophylaxis was postponed in 34.1% (n=31) of patients with DVA and only 2.6% (n=1) without DVA. Proportion of participants who had increased levels of stress due to failed venous insertion was two times higher in participants who experienced DVA compared to those who did not, 82.4% and 41% respectively.

Conclusion(s): Higher DVA prevalence compared with the literature and its impacts on adherence to the treatment, indicate that DVA should be considered as a disease burden and should be taken into account while deciding on interventions (e.g. other routes of administration) to improve health outcomes. (Funded by F. Hoffmann-La Roche).