{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:27:18Z","timestamp":1773008838109,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Haemophilia treatment is costly and only 25% of patients receive adequate care. Although not optimal, Factor VIII (FVIII) low\u2010dose prophylaxis (LDP) may reduce annual joint bleeding rates. Understanding FVIII usage, collected through the Web\u2010Accessible Population Pharmacokinetic Service\u2013Hemophilia (WAPPS\u2010Hemo) platform, and its association with Gross National Income per capita (GNI) and Universal Health Coverage index (UHCI) may provide insights in global disparities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      To provide insights in FVIII use to advocate for LDP in low\u2010income countries by providing: (i) statistical summary of FVIII usage, LDP prevalence, GNI and UHCI in WAPPS\u2010Hemo in 2017\u20132023; (ii) estimation of the relationship between LDP probability (\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>LDP<\/jats:sub>\n                      ) and GNI\/UHCI for children (\u226412 years) and adults; (iii) exploratory comparison of pharmacokinetics (PKs) across LDP\/non\u2010LDP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Descriptive statistics\/graphical summaries for (i) and (iii), mixed\u2010effects logistic regression for (ii).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data from 6223 severe haemophilia patients (ages 0.1\u201392 years) showed that 18% and 32% of countries used \u22641% LDP infusions in children and adults. LDP prevalence rose annually, peaking at 7% for children and 14% for adults. GNI was found lower in LDP\u2010prevalent countries in children. In both children and adults,\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>LDP<\/jats:sub>\n                      demonstrated an inverse association with GNI and UHCI. PK outcomes were similar across LDP status, except potentially for plasma\u2010derived products in children, however limited by sample size.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Underrepresentation of low\u2010resource countries in WAPPS\u2010Hemo underscores the financial challenges in haemophilia treatment. The association between GNI\/UHCI and\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>LDP<\/jats:sub>\n                      suggests cost\u2010driven adoption of LDP in low\u2010resource settings, especially in children. PK outcomes average similarities may facilitate LDP\u2010usage in WAPPS\u2010Hemo.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>NCT02061072, NCT03533504 (ClinicalTrials.gov)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70061","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T08:24:18Z","timestamp":1746865458000},"page":"646-656","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Global Cross\u2010Sectional Database Study of Low Dose FVIII SHL Prophylaxis in Haemophilia A"],"prefix":"10.1111","volume":"31","author":[{"given":"Dagmar M.","family":"Hajducek","sequence":"first","affiliation":[{"name":"School of Pharmacy University of Waterloo  Waterloo Ontario 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Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9014-1653","authenticated-orcid":false,"given":"Andrea","family":"Edginton","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Waterloo  Waterloo Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,10]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Report on the Annual Global Survey 2023","author":"World Federation of Hemophilia","year":"2024"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2012.02909.x"},{"issue":"9","key":"e_1_2_11_4_1","article-title":"Clotting Factor Concentrates Given to Prevent Bleeding and Bleeding\u2010Related Complications in People With Hemophilia A or B","author":"Iorio A.","year":"2011","journal-title":"Cochrane Database of Systematic 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