Wolfgang Miesbach: Half of All Haemophilia Patients on Prophylaxis are Still Having Breakthrough Bleeds
Wolfgang Miesbach, shared post on LinkedIn about a recent article by Sheena Thakkar et al., published in Blood Coagulation and Fibrinolysis, adding:
“Half of all haemophilia patients on prophylaxis are still having breakthrough bleeds – and when they bleed, it’s the joint.
New real-world data from the Adelphi Haemophilia DSP (Thakkar et al., Blood Coagul Fibrinolysis 2026) – 739 men with haemophilia A, 131 with haemophilia B, six countries, physician-reported:
- Emicizumab was already the most-used treatment in HA (40%), EHL factor in HB (55%)
- Yet 48% (HA) and 54% (HB) had breakthrough bleeds since switching to their current prophylaxis
- Among those who bled, joint bleeds dominated in both: 53% and 57%
Haemophilia B was not the milder disease
Prophylaxis is not the same as protection. As long as the joint remains the target organ, ‘well controlled’ on paper can still mean progressive arthropathy in the clinic.
These data were collected in 2020/21 — before Efanesoctocog alfa, gene therapy, and the current generation of non-factor agents reached routine practice.”
Title: Describing the clinical outcomes and treatment landscape for male haemophilia A and B patients in a real-world setting across Europe and the United States
Authors: Sheena Thakkar, Lisa J. Wilcox, Valeria Merla, Anna Kane, Rabiyah Sahar, Chris Blazos, Sophie Lai, Ella Morton, Kieran Wynne-Cattanach, Nathan Ball.
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