Treatment for people with moderate or severe haemophilia aims to prevent bleeding, pain and joint damage. In Australia the usual treatment for most children and young people with severe haemophilia is prophylaxis, where factor concentrate or other new treatment products are injected regularly to keep factor levels high enough to prevent spontaneous bleeds.
There are a few ways to treat haemophilia.
- New treatments that are now in development and becoming available. Some of these new treatments can mean less infusions, or that the treatment product is injected into a muscle instead of into a vein.
- Clotting factor concentrates: Recombinant factor is the most commonly used type of concentrate. This is made by genetic engineering and contains little or no material from human blood or animals. There are several brands available.
- Plasma factor concentrates: are also used by some people. These are made from the plasma (pale yellow fluid part) in human blood.
Clotting factor concentrate can be given:
- “On demand” – before surgery, childbirth or dental treatment, or after an injury or accident, or once a bleed has started.
- As “prophylaxis” – taken regularly to prevent bleeds from happening.
Factor concentrates are infused (injected) into a vein 1-4 times per week at home by parents if their child is young, or by people themselves when they are confident enough to do it, or at the Haemophilia Treatment Centre.
- Desmopressin (DDAVP): This is a synthetic hormone which encourages the body to make factor VIII. It is used for treating some people with mild haemophilia A and some women with bleeding disorder symptoms. DDAVP is given as an injection subcutaneously (into the fatty tissue under the skin) or as a slow injection into a vein.
- Tranexamic acid: This stops some blood clots from breaking down after they have been formed. It can help to treat mouth or nosebleeds, gut bleeding, bleeding after dental work and heavy/long periods. It is usually taken as tablets, syrup or in a mouthwash.
- RICE: (Rest. Ice. Compression and Elevation)It is also important to remember that bleeds into joints should be treated not just with clotting factor but also with RICE. This will control bleeding much more quickly and effectively if used together with treatment products. This can limit severity and duration of a bleed, reduce level of pain, reduce the risk of it recurring, and limit long term damage to joints. Speak to your Haemophilia Centre for more detailed instructions on how to manage a bleed.
Although it is rare, a small percentage of people with haemophilia may develop antibodies – known as ‘inhibitors’ – after having treatment with a clotting factor product. Inhibitors make treatment less effective. There are a number of ways to treat inhibitors and many people are successful in overcoming them while others have ongoing problems.
Date last reviewed: 27 August 2021