Management of bleeding disorders in adults

Authors

  • F. PEYVANDI,

    1. U.O.S. Dipartimentale per la Diagnosi e la Terapia delle Coagulopatie, A. Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione I.R.C.C.S. Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano and Luigi Villa Foundation, Milan, Italy
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  • R. KLAMROTH,

    1. Department of Internal Medicine - Coagulation disorders, Vivantes-Klinikum im Friedrichhain, Berlin, Germany
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  • M. CARCAO,

    1. Division of Hematology/Oncology Child Health Evaluative Sciences, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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  • A. B. FEDERICI,

    1. Department of Internal Medicine, University of Milan, Division of Haematology and Transfusion Medicine, L. Sacco University Hospital, Milan, Italy
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  • G. DI MINNO,

    1. Department of Clinical and Experimental Medicine, Regional Reference Center for Coagulation Disorders, Federico II University, Naples, Italy
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  • V. JIMÉNEZ-YUSTE,

    1. Department of Haematology, La Paz University Hospital, Madrid
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  • E. C. RODRIGUEZ MERCHÁN

    1. Department of Orthopaedics, La Paz University Hospital, Madrid, Spain
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Flora Peyvandi, Fondazione Luigi Villa Fondazione IRCCS Cà GrandaOspedale Maggiore PoliclinicoUniversità degli Studi di Milano Via Pace 9, 20122 Milan, Italy.
Tel.: +02-5510709-55035414; fax: 02-54100125;
e-mail: flora.peyvandi@unimi.it

Abstract

Summary.  Development of FVIII inhibitors is currently the most severe and challenging complication of haemophilia A treatment and represents a very large economic burden for a chronic disease. As a result, clinical research is making major efforts to optimize the therapeutic approaches for this condition. In this section we will review some important aspects of the management of haemophilia in adults, including an overview of bleeding in women with von Willebrand disease, an analysis of FVIII consumption in patients with severe haemophilia A, an update of the ongoing RES.I.ST study, long-term prophylaxis and experience from the Pro.Will study, current evidence relating to economic aspects of the treatment of haemophilic patients with inhibitors (based on the PROFIT study), and an overview of musculoskeletal complications in adults with severe bleeding disorders.

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