Clinical Haemostasis Unit, Louis Pradel Cardiology Hospital, Lyon
EA4609, Claude Bernard University Lyon 1, Lyon
Haemophilia treatment has improved tremendously in the past decade with the development of products with extended half-life, non-replacement therapies and the dawn of gene therapy. However, several issues are still open to debate, including the question of which products are appropriate for which patients and at what dosage? Can two procoagulant products be safely combined in the event of severe breakthrough bleeds? Answers to these questions require the adoption of a personalised approach, taking into account variables including genotype, clinical bleeding phenotype, pharmacokinetics, pharmacodynamics, risk associated with inhibitors, joint condition, physical activity, lifestyle and compliance with treatment. This paper discusses scientific data illustrating the importance of these variables as well as clinical, laboratory and radiological tools that may help to optimise treatment of patients with haemophilia.