Effective treatment of bleeding disorders: A Synthesis of Findings from 21 Studies

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Original Abstract of the Article

Major Research Findings

Research on the treatment of bleeding disorders explores various treatment methods and their effectiveness and safety. reports on the direct data transfer from the Thai Hemophilia Treatment Center registry to the annual global survey of the World Federation of Hemophilia. This signifies a crucial step in gathering patient treatment records and analyzing global trends. 4 analyzes trends in specialized care for females with bleeding disorders within U.S. Hemophilia Treatment Centers, revealing an increasing proportion of female patients. Additionally, 5 reviews the current status and future prospects of activated recombinant coagulation factor VIIa (NovoSeven®) in treating hemophilia and rare bleeding disorders, indicating its effectiveness and safety. Furthermore, 6 investigates perioperative outcomes of patients with bleeding disorders undergoing major surgery at an academic Hemophilia Treatment Center, demonstrating that comprehensive care leads to lower bleeding risks. Other studies delve into post-procedural bleeding rates and hemostatic treatment use following dental procedures 7 , the management of heavy menstrual bleeding 18 , venous access device management 9 , bleeding disorders in implant dentistry 10 , the efficacy of parenteral formulations of desmopressin 11 , polidocanol foam sclerotherapy for hemorrhoidal disease 12 , treatment of rare bleeding disorders 13 , utilization of a surgical database 14 , treatment of hepatitis C virus infection 15 , the use of tranexamic acid for bleeding prevention and treatment 16 , dental treatment of patients with congenital bleeding disorders during the COVID-19 pandemic 17 , latest advancements in bleeding disorder treatment , clinical management of women with bleeding disorders 19 , physician workload in a thrombosis and bleeding disorders center 20 , the use of prophylaxis for rare bleeding disorders 21 , treatment for bleeding prevention in surgery 1 , and antifibrinolytic therapy for oral bleeding prevention in dental procedures 2 , 3 , and the Chinese expert consensus on the diagnosis and treatment of rare bleeding disorders . These studies analyze various aspects, including data collection, treatment trends, drug effectiveness, surgical outcomes, and management during pandemics.

Treatment Summary

5 indicates that activated recombinant coagulation factor VIIa (NovoSeven®) is effective for treating hemophilia and rare bleeding disorders. 16 suggests the effectiveness of tranexamic acid in preventing and treating bleeding in surgery, trauma, and bleeding disorders. Moreover, 21 highlights the potential benefits of prophylaxis in treating rare bleeding disorders. 1 discusses treatment methods for preventing bleeding in surgery for individuals with hemophilia or other congenital bleeding disorders. 2 suggests the effectiveness of antifibrinolytic therapy in preventing oral bleeding in dental procedures for patients with hemophilia or Von Willebrand disease. 3 further examines this antifibrinolytic therapy.

Benefits and Risks

Benefit Summary

Key benefits of treating bleeding disorders include reducing the risk of bleeding and improving quality of life. For instance, 6 demonstrates that comprehensive care at Hemophilia Treatment Centers leads to lower bleeding risks for patients undergoing major surgery. Additionally, 5 shows the effectiveness and safety of activated recombinant coagulation factor VIIa (NovoSeven®). Furthermore, 16 indicates the effectiveness of tranexamic acid in preventing and treating bleeding in surgical, trauma, and bleeding disorder contexts.

Risk Summary

Treatments can come with side effects and risks. 5 investigates the safety of activated recombinant coagulation factor VIIa (NovoSeven®) and reports an overall thrombosis incidence of 0.17% across all approved indications.

Research Comparison

Research Similarities

Many studies aim to assess the effectiveness and safety of various treatment methods for bleeding disorders. These studies collectively strive to improve patient care, develop new therapies, and enhance the quality of life for individuals with bleeding disorders.

Research Differences

Studies vary in their focus on specific disorders, treatment methods, research designs, and outcomes. For example, focuses on data transfer, while 4 delves into treatment trends.

Consistency and Contradictions in Results

Research results exhibit both consistency and contradictions. While 5 demonstrates the effectiveness and safety of activated recombinant coagulation factor VIIa (NovoSeven®), 11 suggests the need for further investigation into the efficacy of intravenous and subcutaneous desmopressin. These discrepancies may be attributed to differences in research designs, target populations, evaluation methods, and other factors.

Real-Life Application Considerations

Research findings may not be universally applicable to all patients, as individual responses can vary. When choosing a treatment approach, factors such as the patient's condition, age, comorbidities, and drug responses should be considered. Consulting a healthcare professional for a thorough evaluation before starting any treatment is essential.

Limitations of Current Research

Current research has limitations. Some studies might have small sample sizes, hindering the generalizability of results. Additionally, discrepancies in research designs and evaluation methods can make result comparison challenging.

Future Research Directions

Future research should prioritize larger-scale studies with more participants and utilize standardized research designs. Comparative studies examining different treatment methods and long-term assessments of treatment effectiveness are also crucial.

Conclusion

Research on bleeding disorder treatment is continuously advancing. New therapies and improved treatment methods are being developed, leading to improved quality of life for patients. However, challenges remain. Future research should address the limitations of current studies and strive to develop more effective and safe treatment options.

Treatment List

Activated recombinant coagulation factor VIIa (NovoSeven®)Tranexamic acidProphylaxisAntifibrinolytic therapy

Literature analysis of 21 papers
Positive Content
20
Neutral Content
0
Negative Content
1
Article Type
0
2
5
8
20
1.

Treatment for preventing bleeding in people with haemophilia or other congenital bleeding disorders undergoing surgery.

Author: CoppolaAntonio, WindygaJerzy, TufanoAntonella, YeungCindy, Di MinnoMatteo Nicola Dario

Haemostatic treatment
Congenital bleeding disorders
Haemophilia

People with bleeding disorders like hemophilia need special treatment to control bleeding during surgery. The type of treatment depends on the specific bleeding disorder, how severe it is, and the type of surgery. The goal is to prevent bleeding for as long as needed, until the wound heals.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

2.

Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions.

Author: van GalenKarin P M, EngelenEveline T, Mauser-BunschotenEvelien P, van EsRobert J J, SchutgensRoger E G

Antifibrinolytic therapy

This systematic review examines the use of antifibrinolytic therapy to prevent bleeding complications during oral or dental procedures in people with inherited bleeding disorders. Antifibrinolytic therapy is a potentially effective and safe treatment, but more research is needed to confirm its effectiveness and safety in this population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions.

Author: van GalenKarin Pm, EngelenEveline T, Mauser-BunschotenEvelien P, van EsRobert Jj, SchutgensRoger Eg

Improved oral surgery outcomes
Reduced bleeding risk

This systematic review examines the use of antifibrinolytic therapy to prevent bleeding complications in people with bleeding disorders undergoing oral or dental procedures. The review found that antifibrinolytic therapy is a safe and potentially effective treatment option.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Trends in dedicated care for females with bleeding disorders within U.S. hemophilia treatment centers.

Author: WheelerAllison P, LimMing Y, HugueletPatricia S, JaffrayJulie, StaberJanice M, FunkhouserKerry, CarpenterShannon L, WeyandAngela C

Female patient increase

This graphical representation shows an increase in the percentage of female patients seen at HTCs, the percentage of females by diagnosis, the number of clinics in existence, and the absolute number of female patients seen over a 10-year period.

LetterA written message for communication and exchange of information between individuals.

Language : English

5.

Current status and future prospects of activated recombinant coagulation factor VIIa, NovoSeven®, in the treatment of haemophilia and rare bleeding disorders.

Author: ShimaMidori

Bleeding management
Bleeding prevention
Thrombosis risk

rFVIIa is a recombinant activated coagulation factor VII used for bleeding episodes and prevention of bleeding in patients with certain bleeding disorders. This review discusses the current status and future prospects of rFVIIa use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Post-procedural bleeding rate and haemostatic treatment use for dental procedures before and after the implementation of a standardized protocol for people with inherited bleeding disorders.

Author: ChampagnePier-Ann, BourassaMichelle, DesjardinsMarie-Pier, CloutierStéphanie, DemersChristine, SingboNarcisse Ulrich, NéronHélène, Pelland-MarcotteMarie-Claude

Reduced bleeding

Using a standardized protocol for dental procedures in people with bleeding disorders increased the use of tranexamic acid, with a nonstatistically significant reduction in procedural bleeding rate.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

SYMPHONY consortium: Orchestrating personalized treatment for patients with bleeding disorders.

Author: CnossenMarjon H, van MoortIris, ReitsmaSimone H, de MaatMoniek P M, SchutgensRoger E G, UrbanusRolf T, LingsmaHester F, MathotRon A A, GouwSamantha C, MeijerKarina, BredenoordAnnelien L, van der GraafRieke, FijnvandraatKarin, MeijerAlexander B, van den AkkerEmile, BieringsRuben, EikenboomJeroen C J, van den BiggelaarMaartje, de HaasMasja, VoorbergJan, LeebeekFrank W G,

Personalized treatment

The SYMPHONY consortium aims to orchestrate personalized treatment in patients with inborn bleeding disorders by investigating the mechanisms behind inter-individual variations of bleeding phenotype.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Management of antithrombotic treatment and bleeding disorders in patients requiring venous access devices: A systematic review and a GAVeCeLT consensus statement.

Author: AnnettaMaria Giuseppina, BertoglioSergio, BiffiRoberto, BresciaFabrizio, GiarrettaIgor, GrecaAntonio La, PanocchiaNicola, PassaroGiovanna, PernaFrancesco, PinelliFulvio, PittirutiMauro, PriscoDomenico, SannaTommaso, ScoppettuoloGiancarlo

Bleeding management
VAD insertion management

The Italian Group of Venous Access Devices (GAVeCeLT) developed a consensus on the management of antithrombotic treatment and bleeding disorders in patients requiring venous access devices (VADs). The consensus recommends a classification of VAD-related procedures based on bleeding risk, and outlines appropriate management for patients with bleeding disorders and those on antithrombotic treatment who require VAD insertion/removal. The recommendations are designed to provide a clear and synthetic list for easy translation into clinical practice.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

Bleeding disorders in implant dentistry: a narrative review and a treatment guide.

Author: RömerPaul, HeimesDiana, PabstAndreas, BeckerPhilipp, ThiemDaniel G E, KämmererPeer W

Bleeding disorder treatment
Treatment guide
Further research needed
Limited evidence

Risk stratification and interdisciplinary cooperation are crucial in treating patients with congenital and acquired bleeding disorders who undergo oral surgery or dental implant procedures.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Efficacy of parenteral formulations of desmopressin in the treatment of bleeding disorders: A systematic review.

Author: SreeramanShreyas, McKinlayStuart, LiAllen, CrowtherMark, MotaloOksana

Hemostasis efficacy

This study investigated whether subcutaneous (SC) DDAVP provides equivalent hemostatic efficacy to intravenous (IV) desmopressin in patients with mild to moderate bleeding tendencies from hemophilia A (HA) or von Willebrand disease (vWD). The study aims to determine if SC DDAVP offers a comparable therapeutic effect.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

Polidocanol foam sclerotherapy in the treatment of hemorrhoidal disease in patients with bleeding disorders: a multicenter, prospective, cohort study.

Author: SalgueiroP, ReiA, GarridoM, RosaB, OliveiraA M, Pereira-GuedesT, MoraisS, Castro-PoçasF

Hemorrhoidal disease treatment
Bleeding complications

This study aimed to compare the efficacy and safety of polidocanol foam sclerotherapy (PFS) in the treatment of hemorrhoidal disease (HD) in patients with and without bleeding disorders (BD).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

13.

Treatment of patients with rare bleeding disorders in the Netherlands: Real-life data from the RBiN study.

Author: MaasDominique P M S M, SaesJoline L, BlijlevensNicole M A, CnossenMarjon H, den ExterPaul L, KruisIlmar C, MeijerKarina, NieuwenhuizenLaurens, PetersMarjolein, SchutgensRoger E G, van HeerdeWaander L, ScholsSaskia E M,

Peri-procedural therapy
RBD treatment

This study found that there is a large heterogeneity in general treatment plans of patients with rare inherited bleeding disorders (RBDs). Bleeding after invasive procedures was reported frequently, both before and after RBD diagnosis, irrespective of factor activity levels and particularly when peri-procedural treatment was omitted.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Tranexamic acid for the prevention and treatment of bleeding in surgery, trauma and bleeding disorders: a narrative review.

Author: OckermanAnna, VanasscheThomas, GaripMelisa, VandenbrieleChristophe, EngelenMatthias M, MartensJeroen, PolitisConstantinus, JacobsReinhilde, VerhammePeter

Bleeding reduction
Seizures
Thrombotic complications

Tranexamic acid (TXA) is effective in reducing bleeding in various surgical and trauma settings. However, there is no consensus on the optimal dose and TXA can cause harm with certain dosages and indications, including an increased risk of seizures and thrombotic events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Practical Recommendations for Treatment of Dental Patients with Congenital Bleeding Disorders during the Covid-19 Pandemic: A Narrative Review.

Author: CzajkowskaSylwia, Rupa-MatysekJoanna, GilLidia, SurdackaAnna

Improved coagulation
COVID-19 impact unknown

This review provides recommendations for the treatment of patients with congenital bleeding disorders (CBD) during the SARS-CoV-2 pandemic.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

Clinical management of woman with bleeding disorders: A survey among European haemophilia treatment centres.

Author: van GalenKarin P M, LavinMichelle, Skouw-RasmussenNaja, IvanovaEva, Mauser-BunschotenEveline, PuntMarieke, RomanaGerychová, ElfvingePetra, D'OironRoseline, Abdul-KadirRezan

Bleeding disorder

A survey of 59 European haemophilia treatment centres (HTCs) found that less than half run a joint clinic for women with bleeding disorders (WBD) and that many HTCs do not offer preimplantation genetic diagnosis or have algorithms for managing acute heavy menstrual bleeding (HMB). The survey highlights the need to prioritize improvement of knowledge and patient care for WBD across Europe.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

Characterization of Physicians Workload in a Reference Center for the Treatment of Thrombotic and Bleeding Disorders<sup>.</sup>

Author: RosatiS, ValeriF, BorchielliniA, GianfredaC M, BalestraG

Workload reduction
Heavy workload

This study found that physicians in an Italian center for the treatment of thrombotic and bleeding disorders experience a heavy workload, averaging 8 hours per day, with interruptions contributing to delays. Ambulatory care accounted for 42% of the total workload, and interruptions during visits were a major factor in delays.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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