Author/Authors :
Habibpanah, Behnaz Pediatric Congenital Hematologic Disorders Research Center - Mofid Children’s Hospital - Shahid Beheshti University of Medical Sciences, Tehran , Tara, Zahra Pediatric Congenital Hematologic Disorders Research Center - Mofid Children’s Hospital - Shahid Beheshti University of Medical Sciences, Tehran , Malek, Fatemeh Pediatric Congenital Hematologic Disorders Research Center - Mofid Children’s Hospital - Shahid Beheshti University of Medical Sciences, Tehran , Ardeshiri, Rezvan Shahid Dastgheib Hemophilia Center - Shiraz University of Medical Sciences , Salimi, Tahmineh Comprehensive Hemophilia Care Center - Iran University of Medical Sciences, Tehran , Saafi, Azam Hematology and oncology center - Omid Hospital - Isfahan University of Medical Sciences , Fasih, Belgheis Aliasghar Hospital - Zahedan University of medical sciences, Zahedan , Managhchi, Mohammad Reza Thrombosis Hemostasis Research Center - Imam Khomeini Hospital - Tehran University of Medical Sciences, Tehran
Abstract :
Background: Bleeding events in hemophilic patients with inhibitors are managed
by bypassing agents. Currently available agents in Iran are recombinant activated
factor VII (rfVIIa; Aryogen, Aryoseven) and Feiba (factor eight inhibitor
bypassing agent). No standardized and accurate assay is currently available for
monitoring the effectiveness of bypassing agents. We suggested that history of
the patients’ response and also their preference could be a reliable method for
assessing the efficacy of bypassing agents; therefore, we designed a multi-centric
discrete choice experiment study to assess the factors that affect the efficacy of
bypassing agents.
Methods: Hemophilic patients older than 2 years with inhibitors who required
bypassing agents for the treatment of bleeding episodes were eligible to
participate in the study. Patients’ preference toward treatment with either Feiba
or Aryoseven was measured with a DCE (discrete choice experiment) design on
a phone interview.
Results: 80 patients were enrolled from 5 centers in Iran. At enrollment, the
mean age was18.6 years (range, 2-50 years). 47 patients (58%) preferred to receive
FEIBA, 21 patients (21.2%) favored Aryoseven and 12 (14.8%) patients claimed
no difference between the two products.
Conclusion: Our results indicated that according to the DCE method, patients
preferred Feiba to Aryoseven while the main reason was their higher efficacy.
In addition, adverse reactions in both groups were almost equal. As a result, it
seems that presence of both products in the market for hemophilic patients with
inhibitors is absolutely essential.
