Safety and efficacy of secondary prophylactic in Patients with severe hemophilia type A and B: A Systematic review and meta-analysis study

Patients with hemophilia recieves coagulation factor replacement for lifetime. In iran, on-demand treatment method is used as standard. Clinical studies have shown significant improvements in clinical and economic outcomes as a result of the use of prophylaxis compared with other therapies. The aim of this study was to evaluate safety and efficacy of prophylaxis in patients with severe hemophilia type A and B.

This is a systematic review and meta-analysis in order to evaluate the safety and efficacy of prophylaxis treatment in patients with severe hemophilia. To this response, all clinical trials, cohorts, and case-control studies which have been investigated, published 1970 to sep 2017 and the results have been analyzed in STATA.

1439 studies were found in primary search and 17 of them had inclusion criteria. The mean annual bleeding  rate in prophylays treatment was 2.8 times per person/year. This study also showed that in prophylaxis, the average incidence of adverse effects was 0.13 cases, and the severe adverse effects was 0.06 cases per person/year.
Discussion and

The analysis of the studies entered in this evaluation showed that the adverse effects were significantly lower in patients treated with prophylaxis than in patients treated with on-demand treatment. This difference was observed in severe adverse effect but it was not statistically significant and this shows that prophilaxis is safer than on-demand method. The lower annual bleeding rate in prophylaxis compared with the on-demand treatment method is also a sign of the effectiveness of prophilaxis.