What is Prophylaxis?

The term prophylaxis refers to the preventative treatment of medication. This term is widely used for many chronic medical conditions requiring routine ongoing therapies such as heart conditions, bleeding disorders, HIV and others. In the case of hemophilia it is used to mean treating on a regular schedule.

In the realm of bleeding disorders there are three main treatment protocols used to manage the bleeding episodes.

• In the "as needed" or "on demand" (prn) protocol, patients only use the medications such as clotting factor, platelets, etc. when they are actually having a bleeding episode. Once the bleed has resolved, the patient stops treatment until the next problem arises.
• In a prophylaxis treatment protocol the treatment is routine and intended to prevent bleeding episodes. This often involves the administration of the medication multiple times each week.
• The third treatment method combines the two above. While not treating routinely, the patient often infuses prior to taking part in more hazardous activities such as a sports game or rollercoaster ride.

What are the pros & cons to prophylaxis?

While the decision of whether or not prophylaxis treatment is right for a patient is something that really requires a lot of thinking and discussion between the patient and their doctor, there are some pros and cons that can be easily seen and taken into consideration. Again it's important to remember that each person is different and what may work best for some is not right for others. Below is a simple list of things that a person may want to take into account when considering prophylaxis treatment.

• Frequency of bleeding episodes / severity of bleeding disorder - If a person with a bleeding disorder has bleeds often, prophylactic treatment may allow for a better quality of life and actually reduce the use of the expensive medications. For patients with less frequent bleeding problems, prophylaxis might cause a higher usage of clotting factor.
• Joint damage & target joints - Prophylaxis treatment can help prevent some joint damage and development of target joints. In patients that already have extensive joint damage and target joints it may help to reduce the frequency of bleeding into those joints.
• Aversion to needles - Prophylaxis treatment for a person with a bleeding disorder usually means frequent IVs. While people with severe bleeding problems typically grow accustomed to needle pokes, it's never an enjoyable process. For those with less pronounced veins, this may mean a getting port to make the infusion process easier.
• Time & commitment considerations - Treating prophylactically takes some dedication and planning. Setting a few minutes aside a few times a week may seem insignificant and easy but prophylaxis only works when the patient follows the protocol and doesn't forget to treat.