Introduction: The management of hemophilia A has undergone a revolution. Improving patients`compliance
with prophylaxis has become a key focus [1.] Although treatment standards are high, daily practice reveals variable outcomes:
Patients are still bleeding, subclinical bleeds occur despite current prophylaxis,
which still needs to be optimized [2]
[3]. There has been evidence, trough that levels of 3% factor VIII (FVIII) are not adequate
to fully prevent synovitis in all patients [4]. Unmet needs remain, joint and functional impairment and acute and chronic pain
occur. Evidence suggests, that FVIII activity levels of up to 50% may be needed to
achieve a near-zero joint bleed rate [5]. The German S2k guidelines on synovitis recommend maintaining factor trough levels
of≥30% for 6 months for the treatment of chronic synovitis. One key to improve the
prophylaxis and its outcome in the real world setting is an educated, committed and
adherent patient [6]
[7].
Method: To raise awareness for joint health and support communication between physicians
and their patients, an innovative tool has been developed. Using innovative technology,
the inSight Joint Health tool lets users explore immersive 3D models, detailed animated
videos, medical scan images and informative messaging about joint health in haemophilia.
The tool explains the pathophysiology behind subclinical and clinical bleeds and provides
guidance on how long-term joint health can be preserved. It can be applied to support
patient education and can help to support the shared decision making process in haemophilia
treatment.
Results: The inSight Joint Health tool enables to communicate how both, clinical and subclinical
bleeds, can contribute to joint damage and highlight that an optimized prophylactic
therapy supports long-term joint health. A step forward in the treatment of hemophilia
A has recently been achieved with a new class of factor VIII concentrate, the high-sustained
FVIII: Efanesoctocog alfa is a B domain-deleted single-chain FVIII connected to the
D'D3 domain of von Willebrand Factor (vWF). Efanesoctocog alfa provides a 3-4
times longer half-life compared to standard and extended half-life FVIII products
[8]
[9]
[10].
Conclusion: Achieving high FVIII activity levels with current standard and extended half-life
FVIII replacement therapies is associated with a high treatment burden. Innovative
treatment options may provide high sustained FVIII activity levels and improve patient
outcomes [7]. Application of the tool might support haemophilia-specific acceptance and commitment
to a prophylactic treatment. Physicians and patients evaluated the inSight Joint Health
tool as beneficial tool,supporting shared decision making and enhancing the adherence
to a prophylactic therapy regimen contributing to long-term joint health.
