When I was raising a child with hemophilia over 20 years ago, all factor dosing was based on our child’s weight and severity of an injury. No one ever talked about PK. What is PK, you ask? Read below and find out! It’s essential to know if you want to individualize the dosing schedule for you or your loved one with hemophilia!
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We know that regardless of any similarities, no two individuals with hemophilia are the same. For example, you and another person with hemophilia who are the same age and weight may require different amounts of factor, depending on how your body uses factor.1
One of the key elements in individualizing factor treatment is understanding and utilizing pharmacokinetics (PK). This is the study of how your body uses the medicine you take,2 which in turn helps predict the factor coverage that is available within your body. PK helps predict how the treatment is working with your body. Remember, no two individuals are the same, so factor is used or removed from the blood at different rates depending on your individual PK profile.3
Your PK profile is developed during PK analysis, where your healthcare provider (HCP) draws your blood at very specific times to determine your factor levels.4,5 PK analysis helps your HCP identify and understand4,6,7:
- Highest level of factor in your body after infusion (peak)
- Lowest factor level after time has passed (trough)
- Amount of time it takes for half of the infused factor to be removed from the bloodstream, known as the half-life
This PK information can help your HCP determine an optimal treatment plan for you by adjusting your infusion dose and frequency (how often factor is infused), based on how your body uses factor.1 Your HCP will also take a close look at your lifestyle and other activities, as these can have an impact on your bleeding risk. As you can see, there are many different characteristics to consider when determining the right treatment plan for you.
Individualizing prophylaxis (routine infusion of factor to prevent bleeds) may help improve the likelihood of zero bleeds while also helping to preserve joint health.8 Your joint health is very important; every joint bleed matters. It is recommended to start prophylaxis early, especially in childhood or adolescence, to help preserve your joints.9
We at Shire understand that individualized factor treatment is key. It is necessary to tailor your factor treatment to meet your unique needs. When it comes to treating hemophilia, there is no one-size-fits-all approach.1
Talk to your healthcare provider about factor treatment— an option that lets you individualize your prophylaxis regimen to meet your unique needs. Visit www.bleedingdisorders.com to learn more about factor treatment.
- Valentino LA. Considerations in individualizing prophylaxis in patients with haemophilia A. Haemophilia. 2014;20:607-615.
- Le J. Overview of pharmacokinetics. Merck Manual. https://www.merckmanuals.com/professional/clinical-pharmacology/pharmacokinetics/overview-of-pharmacokinetics. Accessed July 17, 2018.
- Collins PW, Björkman S, Fischer K, et al. Factor VIII requirement to maintain a target plasma level in the prophylactic treatment of severe hemophilia A: influences of variance in pharmacokinetics and treatment regimens. J Thromb Haemost. 2010;8(2):269-275.
- Poon MC, Jackson S, Brown M, McClure W. Clotting factor therapy. All About Hemophilia: A Guide for Families. Montreal, Quebec, Canada: Canadian Hemophilia Society; 2010:1-33.
- Lee M, Morfini M, Schulman S, Ingerslev J; and Factor VIII/Factor IX Scientific and Standardization Committee on the International Society on Thrombosis and Haemostasis. The design and analysis of pharmacokinetic studies of coagulation factors. International Society on Thrombosis and Haemostasis. https://c.ymcdn.com/sites/www.isth.org/resource/group/d4a6f49a-f4ec-450f-9e0f-7be9f0c2ab2e/official_communications/fviiipharmaco.pdf. Published March 21, 2001. Accessed June 1, 2018.
- University of Virginia Health System. Obtaining trough blood levels. https://med.virginia.edu/neurology/wp-content/uploads/sites/235/2015/11/obtaining-trough-blood-levels.pdf. Accessed July 27, 2018.
- Medical Dictionary. Definition of Cmax. Farlex Inc: Huntingdon Valley, PA; 2018. http://medical-dictionary.thefreedictionary.com/Cmax. Accessed July 30, 2018.
- Poon M, Lee A. Individualized prophylaxis for optimizing hemophilia care: can we apply this to both developed and developing nations? Thromb J. 2016;14(suppl 1):65-71.
- Bertamino M, Riccardi F, Banov L, et al. Hemophilia care in the pediatric age. J Clin Med. 2017;6(54):1-13.
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