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Hamostaseologie. 2019 Feb 5. doi: 10.1055/s-0039-1677874. [Epub ahead of print]

Prevalence of Obesity in Young Patients with Severe Haemophilia and Its Potential Impact on Factor VIII Consumption in Germany.

Author information

1
Paediatric Haemophilia Centre, Dr. von Hauner Children's Hospital, LMU Munich, Munich, Germany.
2
Department of Paediatrics, Paediatric Haemophilia Centre, Goethe University, University Hospital Frankfurt, Frankfurt, Germany.
3
Institute of Experimental Haematology and Transfusion Medicine, University Clinic Bonn, Bonn, Germany.
4
Coagulation Centre Rhine-Ruhr, Medical Thrombosis and Haemophilia Treatment Centre and Specialized Laboratory for Coagulation Disorders/Haemophilia, Duisburg, Germany.
5
Department of Paediatric Haematology and Oncology, University Hospital for Children and Adolescents, Friedrich Schiller University, Jena, Germany.
6
Department of Paediatric Haemostaseology, University Hospital 'Carl Gustav Carus', Technical University, Dresden, Germany.
7
Department of Paediatric Haematology, Oncology and Haemostaseology, University Childrens Hospital Leipzig, Leipzig, Germany.
8
Centre for Haemostaseology, University Hospital Leipzig, Leipzig, Germany.

Abstract

in English, German

Similar to the general population, overweight and obesity have increasingly become a medical and economic burden also in patients with haemophilia in industrialized nations. In this study in seven German haemophilia centres, we identified a prevalence of overweight and obesity of 25.2% among 254 young patients <30 years (median: 13 years; range: 0-30 years) with severe haemophilia A and without a history of inhibitors. The median FVIII dosage based on bodyweight was significantly higher in normal weight compared with overweight or obese patients (96.9 vs. 72.9 IU/kg/week, respectively; p < 0.0001). This suggests that an individualized dosing regime which might be based on FVIII pharmacokinetics, physical activity and pre-existing haemophilic arthropathy is applied rather than dosing by bodyweight only. The bleeding rates observed in obese (median: 1; range: 0-17) versus normal weight patients (median: 2; range: 0-28) did not differ significantly (p = 0.057). Lower bleeding rates might be due to reduced activity or expected higher FVIII plasma levels in overweight patients. Due to the increasing prevalence of overweight/obesity in patients with haemophilia an interdisciplinary approach for individualized haemophilia treatment and weight loss programmes might be helpful for optimal and economical treatment for this group of patients.

PMID:
30722069
DOI:
10.1055/s-0039-1677874

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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