{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:13:38Z","timestamp":1776086018028,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Despite receiving standard half\u2010life (SHL) factor VIII (FVIII) concentrates prophylaxis, some severe haemophilia\u00a0A (HA) patients still encounter spontaneous breakthrough bleeding. Individualized pharmacokinetic (PK)\u2010guided dosing of extended half\u2010life (EHL) FVIII concentrates may reduce their bleeding events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare clinical outcomes before and after switching low\u2010dose prophylaxis using weight\u2010based SHL FVIII to PK\u2010guided EHL FVIII concentrates, taking into consideration of a trough FVIII activity at 1\u00a0IU\/dl above natural baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this single\u2010centre prospective cohort, Thai severe or moderate HA (FVIII activity \u22643\u00a0IU\/dl) patients receiving low\u2010dose weight\u2010based SHL FVIII prophylaxis were enrolled. After a 3\u2010day wash\u2010out period, participants underwent low\u2010dose EHL FVIII prophylaxis with PK\u2010based adjustment (myPKFiT<jats:sup>\u00ae<\/jats:sup>) for 6 months. The annualized bleeding rates (ABR), the annualized joint bleeding rates (AJBR), the haemophilia\u2010specific quality\u2010of\u2010life (Haemo\u2010QoL or Haemo\u2010QoL\u2010A) scores, the Hemophilia Joint Health Scores (HJHS) and the annualized FVIII consumption were compared between the two prophylactic periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 15 eligible subjects (mean age 18.7\u00a0\u00b1\u00a06.7 years), ABR, AJBR and HJHS were significantly reduced (mean differences of \u201011.1\u00a0\u00b1\u00a04.9 bleeds\/year, \u201010.4\u00a0\u00b1\u00a05.2 joint bleeds\/year and \u20105.1\u00a0\u00b1\u00a01.5 marks, respectively; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 for all comparisons) after switching regimen. The quality\u2010of\u2010life scores had also improved (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001). Nonetheless, FVIII consumption tended to increase despite no statistical significance (means of 1240.9\u00a0\u00b1\u00a0531.3 SHL FVIII IU\/kg\/year versus 1591.7\u00a0\u00b1\u00a0438.9 EHL FVIII IU\/kg\/year; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This is the first low\u2010dose, PK\u2010guided, EHL FVIII prophylaxis clinical study in Thailand. Benefits and practicability of this personalized regimen may support the implementation of regular FVIII prophylaxis in developing countries with budget constraints. ClinicalTrials.gov NCT05281185.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.14700","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T15:10:30Z","timestamp":1669043430000},"page":"156-164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical outcomes of low\u2010dose pharmacokinetic\u2010guided extended half\u2010life versus low\u2010dose standard half\u2010life factor VIII concentrate prophylaxis in haemophilia A patients"],"prefix":"10.1111","volume":"29","author":[{"given":"Arunothai","family":"Rakmanotham","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology and Oncology Department of Pediatrics Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Integrative and Innovative Hematology\/Oncology Research Unit Department of Pediatrics Faculty of Medicine Chulalongkorn University  Bangkok 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Department of Pediatrics Faculty of Medicine Chulalongkorn University  Bangkok 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