Safety and efficacy of secondary prophylactic in Patients with severe hemophilia type A and B: A Systematic review and meta-analysis study

Context: Patients with hemophilia recieves coagulation factor replacement for lifetime. In iran, on-demand treatment method is used as standard. Clinical studies have shown significant improvements in clinical and economic outcomes as a result of the use of prophylaxis compared with other therapies. The aim of this study was to evaluate safety and efficacy of prophylaxis in patients with severe hemophilia type A and B. Evidence Acquisition: This is a systematic review and meta-analysis in order to evaluate the safety and efficacy of prophylaxis treatment in patients with severe hemophilia. To this response, all clinical trials, cohorts, and case-control studies which have been investigated, published 1970 to sep 2017 and the results have been analyzed in STATA. Results: 1439 studies were found in primary search and 17 of them had inclusion criteria. The mean annual bleeding rate in prophylays treatment was 2.8 times per person/year. This study also showed that in prophylaxis, the average incidence of adverse effects was 0.13 cases, and the severe adverse effects was 0.06 cases per person/year. Conclusion: The analysis of the studies entered in this evaluation showed that the adverse effects were significantly lower in patients treated with prophylaxis than in patients treated with on-demand treatment. This difference was observed in severe adverse effect but it was not statistically significant and this shows that prophilaxis is safer than on-demand method. The lower annual bleeding rate in prophylaxis compared with the on-demand treatment method is also a sign of the effectiveness of prophilaxis.