4. When Should we Switch from On-Demand to Prophylaxis Regimen?

  1. Emérito-Carlos Rodríguez-Merchán MD, PHD2,3 and
  2. Leonard A. Valentino MD4
  1. José A. Aznar MD,
  2. Andrés Moret MS,
  3. Lydia Abad-Franch MD,
  4. Ana R. Cid MD,
  5. Saturnino Haya MD and
  6. Felipe Querol MD, PhD, PT

Published Online: 12 MAY 2011

DOI: 10.1002/9781119979401.ch4

Current and Future Issues in Hemophilia Care

Current and Future Issues in Hemophilia Care

How to Cite

Aznar, J. A., Moret, A., Abad-Franch, L., Cid, A. R., Haya, S. and Querol, F. (2011) When Should we Switch from On-Demand to Prophylaxis Regimen?, in Current and Future Issues in Hemophilia Care (eds E.-C. Rodríguez-Merchán and L. A. Valentino), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119979401.ch4

Editor Information

  1. 2

    Department of Orthopedic Surgery and Hemophilia Unit, La Paz University Hospital, Spain

  2. 3

    School of Medicine, Autonomous University, Madrid, Spain

  3. 4

    Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago, IL, USA

Author Information

  1. La Fe University Hospital, Valencia, Spain

Publication History

  1. Published Online: 12 MAY 2011
  2. Published Print: 13 MAY 2011

ISBN Information

Print ISBN: 9780470670576

Online ISBN: 9781119979401



  • prophylaxis;
  • on-demand;
  • switch;
  • hemophilia;
  • adolescent;
  • adult


Prophylaxis is the regular administration of factor concentrates in order to prevent spontaneous hemorrhages and is the recommended therapy for patients with severe hemophilia. There is a global consensus about starting prophylaxis early (before the development of joint damage), continuing prophylaxis in adolescents and possibly maintaining the prophylaxis into adult age. Maintaining prophylaxis in adults that started it early must be individualized. Starting secondary prophylaxis in adolescents and adults that already have joint damage reduces bleedings and can provide those patients some of the same benefits observed in pediatric patients. The results of the published works are encouraging even yet there is no evidence which shows the efficacy of prophylaxis in these groups.