PB1221 - Low dose prophylaxis among patients with Severe Hemophilia A & B at major Hemophilia Treatment Centres in Malaysia: Three years Retrospective Study

Tuesday, June 25, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

VS

Veena Selvaratnam

Haematologist Consultant
Ampang Hospital, Ministry of Health, Malaysia
Ampang, Selangor, Malaysia

Co-Author(s)

AG

Ai Sim Goh

Consultant Hematologist
Hospital Pulau Pinang
George Town, Pulau Pinang, Malaysia
LC

Lee Ping Chew

Consultant Hematologist
Hospital Umum Sarawak
Kuching, Sarawak, Malaysia
Jameela Sathar, MD, MRCP, FRCPath

Haematologist Consultant
Ampang Hospital, Ministry of Health, Kuala Lumpur, Malaysia
Petaling Jaya, Selangor, Malaysia

Co-Author(s)

TK

Tanusha Kunju, MD

Ampang Hospital, Malaysia
Ampang, Selangor, Malaysia

Co-Author(s)

SN

Syazarin Fidhora Nasution

Medical Officer
Hospital Ampang
Ampang, Selangor, Malaysia
YL

Yi Lin Lee

Pharmacist
Hospital Ampang
AMPANG, Selangor, Malaysia
SE

Syed Carlo Edmund

Research Officer
Hospital Ampang
AMPANG, Selangor, Malaysia

Background: Prophylaxis aims for reduction in bleeding rates and its complications among severe Hemophilia patients. Major Hemophilia Treatment Centre(HTC) in Malaysia uses the World Bleeding Disorders Registry(WBDR) to gather data for patients since April 2019.

Aims: We aim to describe the epidemiology of Congenital Hemophilia in 3 major HTC’s (Ampang Hospital, Pulau Pinang Hospital, Hospital Umum Sarawak) in Malaysia to determine the Annual Factor Usage(AFU), average prophylaxis dosage, the average low prophylaxis dosage used and its relations to bleeding events by looking at Annual Bleeding Rate(ABR), Annual Spontaneous Bleeding Rate(ABRs) and Annual Joint Bleeding Rate( AJBR) between 2020-2022.

Methods: A descriptive study was done on 143 patients with Severe Hemophilia without inhibitors (≥0.5 Bethesda Unit) on Short Half Life (SHL) prophylaxis. The annualized bleeding rate (ABR) was calculated based on the total number of bleeds reported at visits in the year of interest, divided by the observation period in days, and annualized. The ABR for total bleed, spontaneous(ABRS) and joint bleeds(AJBR) were analyzed to see if there were any differences in the low dose group using Man Whitney U test.

Results: Majority of our patients were SHA (84.6%) and 15.4% were SHB with a median age of 34 years old. Average prophylaxis used is 94178.21 IU/ Year. Majority of patients were on intermediate dosage (66.2%) followed by low dose prophylaxis (31.0%) and high dose prophylaxis (2.8%). The average of low dose prophylaxis used was only 1000 IU/Kg/Year. Most frequent bleed was joint bleed (51%). Annual Bleeding Rates were compared with low dose prophylaxis using Man Whitney U test with no significant difference found (p value >0.05)

Conclusion(s): There was no significant difference found between ABR, ABRS and AJBR with the low, intermediate and high dose population. Further studies need to be carried out to see the correlation between low dose prophylaxis with the bleeding rates.