Factor VIII half-life and intensity of treatment in hemophilic patients

It is well known that severe hemophilic patients have a considerable different factor VIII half-lives. Details of the effect of the inter-individual variation of Factor VIII half-live on treatment or clinical outcome has not been reported. Accordingly, during many years several strategies in prophylactic treatment for severe haemophilia have been used (intermediate-dose of plasma FVIII versus high-dose regime). In the retrospective study by van Dijk et al. (see page 494), the authors show an association between factor VIII half-live and the clinical characteristics of patients with severe hemophilia. Patients with shorter factor VIII half-life need more intensive treatment to prevent joint bleeds and arthropaty than patients with longer factor VIII half-life. Further prospective studies should necessary to confirm whether assessment of factor VIII half-life before the start of prophylaxis could modify the intensity of treatment and prevention of arthropaty among patients with severe hemophilia.