Haemophilia care in Asia: Learning from clinical practice in some Asian countries
Issued Date
2024-01-01
Resource Type
ISSN
13518216
eISSN
13652516
Scopus ID
2-s2.0-85189511778
Pubmed ID
38523289
Journal Title
Haemophilia
Rights Holder(s)
SCOPUS
Bibliographic Citation
Haemophilia (2024)
Suggested Citation
Angchaisuksiri P., Amurao-Abiera M., Chou S.C., Chewcharat P., Chozie N.A., Gomez R., Leng T.S., Lin P.C., Mai N.T., Muda Z., Seth T., Sosothikul D., Siu-Ming Wong R. Haemophilia care in Asia: Learning from clinical practice in some Asian countries. Haemophilia (2024). doi:10.1111/hae.14998 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/97933
Title
Haemophilia care in Asia: Learning from clinical practice in some Asian countries
Author's Affiliation
Ramathibodi Hospital
Chinese University of Hong Kong, Faculty of Medicine
Kaohsiung Medical University Chung-Ho Memorial Hospital
National Taiwan University Hospital
Philippine Children's Medical Center
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Singapore General Hospital
All India Institute of Medical Sciences, New Delhi
Chinese University of Hong Kong
Faculty of Medicine, Chulalongkorn University
Singapore
Hospital Tunku Azizah
Pfizer (Thailand) Limited
National Institute of Hematology and Blood Transfusion
Chinese University of Hong Kong, Faculty of Medicine
Kaohsiung Medical University Chung-Ho Memorial Hospital
National Taiwan University Hospital
Philippine Children's Medical Center
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Singapore General Hospital
All India Institute of Medical Sciences, New Delhi
Chinese University of Hong Kong
Faculty of Medicine, Chulalongkorn University
Singapore
Hospital Tunku Azizah
Pfizer (Thailand) Limited
National Institute of Hematology and Blood Transfusion
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: The healthcare systems in Asia vary greatly due to the socio-economic and cultural diversities which impact haemophilia management. Methods: An advisory board meeting was conducted with experts in haemophilia care from Asia to understand the heterogeneity in clinical practices and care provision in the region. Findings: The overall prevalence of haemophilia in Asia ranges between 3 and 8.58/100,000 patients. Haemophilia A was more prevalent as compared to haemophilia B with a ratio of around 5:1. There is under-diagnosis in the region due to lack of diagnosis, registries and/or lack of appropriate facilities in suburban areas. Most patients are referred to the haematologists by their families or primary care physicians, while some are identified during bleeding episodes. Genetic testing faces obstacles like resource constraints, services available at limited centres and unwillingness of patients to participate. Prophylaxis is offered for people with haemophilia (PWH) with a severe bleeding phenotype. Recombinant factors are approved in most countries across the region and are the preferred therapy. The challenges highlighted for not receiving a high standard of care include patients’ reluctance to use an intravenous treatment, poor patient compliance due to frequency of infusions, budget constraints and lack of funding, insurance, availability and accessibility of factor concentrates. Prevalence of neutralizing antibodies ranged from 5% to 20% in the region. Use of immune tolerance induction and bypassing agents to treat inhibitors depends on their cost and availability. Conclusion: Haemophilia care in Asia has evolved to a great extent. However, some challenges remain for which a strategic approach along with multi-stakeholder involvement are needed.