How can joint bleeds be prevented in hemophilia A?

Question

Hi doctor,

My 11-year-old nephew was recently diagnosed with hemophilia A. We are particularly concerned about his frequent joint bleeds. How can these episodes be prevented, especially during his sports activities? Are prophylactic treatments effective for managing his condition, and how often would he need them? Additionally, should our family undergo genetic testing to determine who might be carriers?

Thank you, doctor.

Answer 1

Hi,

Welcome to Icliniq.com.

I understand your concern.

Hemophilia A is a condition where one of the clotting factors in the blood, specifically factor VIII, is deficient. Genetic testing of parents is recommended for future siblings, and testing of other siblings should be done for early diagnosis.

Prophylaxis is required to maintain a minimal level of factor VIII by administering it regularly. The frequency depends on the severity of hemophilia. Severe cases may require it twice a week, while mild cases may need it once every two weeks. Since he has been diagnosed at this age, he likely has a mild deficiency. However, if you can share his blood reports, I can provide more specific advice.

There are some new medications available for prophylaxis, though they are costly. If administering factor VIII does not help, you can consider these options. Additionally, a new treatment modality called gene therapy is available, but it is still in the trial phase and not yet widely used.

You should avoid activities that carry a high risk of injury, such as dangerous sports like rugby. It would be better to encourage him to engage in indoor games or sports activities with a lower risk of injury. Consult your specialist doctor, discuss with them, and take the medicines with their consent.

I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.