There was no marked reduction of the annual FVIII consumption in

There was no marked reduction of the annual FVIII consumption in older patients. The average annual FVIII consumption from year to year is relatively constant in patients with severe haemophilia APO866 molecular weight A. Adults receive about 150 000 IU per patient which translates to approximately 2000 IU kg−1 bodyweight in adults: values were 2065 IU kg−1 bodyweight in 2005 vs. 2141 IU kg−1 bodyweight in 2009. The attitude

of clinicians to plasma-derived and recombinant products in eastern Germany is reflected in the pattern of FVIII consumption (Fig. 2). In 2005, approximately 80% of adults were treated with plasma-derived products, whereas more than 40% of adults received recombinant products in 2009, indicating

a slow uptake of newer agents. This is explained by historical practice. Until German reunification in 1991, patients with haemophilia in the eastern region of Germany were mainly INK128 treated with cryoprecipitate, so the shadow of the HIV catastrophe bypassed that region. In adults, the switch from cryoprecipitate to plasma-derived FVIII products was so successful that clinicians and patients were satisfied with this approach. In the eastern part of Germany, 64% of patients undergo individualized prophylactic treatment. These regimens differ from those in other countries: [13] prophylaxis in our cohort was ID-8 defined as at least one FVIII infusion per week without a bleed. To put our data in context we compared them to findings from the United Kingdom Haemophilia Centres Doctors’ Organisation [14]. The FVIII consumption in the UK varies widely across different regions and does not increase in specific age groups but is increasing per year in

all age groups [14]. Overall consumption of FVIII from 2005 to 2009 in eastern parts of Germany was relatively constant, at approximately 44 million IU year−1. The rate of consumption in eastern regions of Germany appears broadly comparable to that in the UK, although it should be noted that in the UK recombinant FVIII is used more frequently [14]. Several conclusions can be drawn from these data. First, at least in the eastern part of Germany, consumption of FVIII was similar from 2005 to 2009, suggesting no trend towards its increased use. Second, individualized prophylactic treatment in adult patients is common, with nearly two-thirds of patients receiving this strategy. Lastly, in our cohort there was no reduction in FVIII consumption in higher age groups, in contrast to reports from the UK. These findings raise yet more questions.

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