{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T05:02:19Z","timestamp":1779858139569,"version":"3.53.1"},"reference-count":18,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012112","name":"Sobi","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012112","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Introduction: Extended half-life (EHL) factor VIII (FVIII) products aim to reduce treatment burden and improve bleeding control in hemophilia A. Real-world evidence remains essential to complement clinical trials. Aim: To evaluate clinical outcomes following switching from standard half-life (SHL) rFVIII to efmoroctocog alfa in routine clinical practice in Greece. Methods: Multicenter observational pre\u2013poststudy including patients with moderate to severe hemophilia A. Outcomes were assessed during the 12 months before and after switching. The primary endpoint was change in annualized bleeding rate (ABR). Secondary endpoints included annualized joint bleeding rate (AjBR), infusion frequency, joint health, pain, and FVIII consumption. Results: Sixty patients were included. Following switching, ABR decreased from 6.8 to 3.2 (53%), and AjBR from 6.4 to 2.9 (55%), p &lt; 0.001. Reductions were more pronounced in patients switching from on-demand treatment, while more modest improvements were observed among patients already on prophylaxis. HJHS significantly decreased from 17.9 to 11.5 (p &lt; 0.007), accompanied by a decrease in pain scores (p &lt; 0.001), in available paired subsets. Weekly infusion frequency decreased (3.2 to 2.2; p &lt; 0.001), while mean dose per infusion increased, resulting in no consistent reduction in total annual FVIII consumption. No inhibitor or treatment-related adverse events have been observed. Conclusions: Switching to efmoroctocog alfa in routine practice was associated with improved bleeding outcomes, reduced infusion frequency, and better joint-related parameters. These findings support the real world feasibility and clinical utility \u03bff EHL FVIII therapy, while further controlled studies are needed to better define the independent effect of product switching from changes in treatment regimen and other potential confounders.<\/jats:p>","DOI":"10.3390\/life16060881","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:06:26Z","timestamp":1779696386000},"page":"881","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing Hemophilia Care: Real-World Outcomes Following Switching to Extended Half-Life Factor VIII in Greece\u2014The TOOL Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1792-0597","authenticated-orcid":false,"given":"Helen","family":"Pergantou","sequence":"first","affiliation":[{"name":"Haemophilia Centre, Haemostasis and Thrombosis Unit, Aghia Sophia Children\u2019s Hospital of Athens, Thivon 1 and Papadiamantopoulou, Goudi, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Vakalopoulou","sequence":"additional","affiliation":[{"name":"Haemophilia Centre of Northern Greece, 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efrosyni","family":"Nomikou","sequence":"additional","affiliation":[{"name":"Blood Tranfusion Unit, Haemophilia Centre, Ippokration General Hospital of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Economou","sequence":"additional","affiliation":[{"name":"1st Pediatric Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kouramba","sequence":"additional","affiliation":[{"name":"Blood Transfusion Unit, National Reference Centre for Congenital Bleeding Disorders, Laiko General Hospital of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7865-9823","authenticated-orcid":false,"given":"Aikaterini","family":"Michalopoulou","sequence":"additional","affiliation":[{"name":"Haemophilia Centre, Haemostasis and Thrombosis Unit, Aghia Sophia Children\u2019s Hospital of Athens, Thivon 1 and Papadiamantopoulou, Goudi, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8232-3767","authenticated-orcid":false,"given":"Athina","family":"Dettoraki","sequence":"additional","affiliation":[{"name":"Haemophilia Centre, Haemostasis and Thrombosis Unit, Aghia Sophia Children\u2019s Hospital of Athens, Thivon 1 and Papadiamantopoulou, Goudi, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Moka","sequence":"additional","affiliation":[{"name":"Haemophilia Centre of Northern Greece, 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4044-3503","authenticated-orcid":false,"given":"Alkistis","family":"Adramerina","sequence":"additional","affiliation":[{"name":"1st Pediatric Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Katsarou","sequence":"additional","affiliation":[{"name":"Blood Transfusion Unit, National Reference Centre for Congenital Bleeding Disorders, Laiko General Hospital of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1177\/1076029617733041","article-title":"Health-Related Quality of Life and Association With Arthropathy in Greek Patients with Haemophilia","volume":"24","author":"Varaklioti","year":"2017","journal-title":"Clin. Appl. Thromb. Haemost."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1111\/hae.12074","article-title":"Treatment Guidelines Working Group on Behalf of The World Federation of Hemophilia. Guidelines for the management of haemophilia","volume":"19","author":"Srivastava","year":"2013","journal-title":"Haemophilia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1055\/s-0037-1615621","article-title":"Definitions in haemophilia. Recommendation of the scientific subcommittee on factor VIII and factor IX of the scientific and standardization committee of the International Society on Thrombosis and Haemostasis","volume":"85","author":"White","year":"2001","journal-title":"Thromb. 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Thromb. Haemost."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"968081","DOI":"10.1155\/2014\/968081","article-title":"Psychometric properties of the Greek Haem-A-QoL for measuring quality of life in Greek haemophilia patients","volume":"2014","author":"Varaklioti","year":"2014","journal-title":"BioMed Res. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/hae.14576","article-title":"Clinical application of extended half-life factor VIII in children with severe haemophilia A","volume":"28","author":"Dettoraki","year":"2022","journal-title":"Haemophilia"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/6\/881\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T04:11:59Z","timestamp":1779855119000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/6\/881"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,25]]},"references-count":18,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["life16060881"],"URL":"https:\/\/doi.org\/10.3390\/life16060881","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,25]]}}}