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Olivieri, Martin; Königs, Christoph; Heller, Christine; Horneff, Silvia; Oldenburg, Johannes; Halimeh, Susan; Kentouche, Karim; Knoefler, Ralf; Fischer, Lars; Pfrepper, Christian; Kurnik, Karin und Bidlingmaier, Christoph (2019): Prevalence of Obesity in Young Patients with Severe Haemophilia and Its Potential Impact on Factor VIII Consumption in Germany. In: Hamostaseologie, Bd. 39, Nr. 4: S. 355-359

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Abstract

Similar to the general population, overweight and obesity have increasingly become a medical and economic burden also in patients with haemophilia in industrialized nations. In this study in seven German haemophilia centres, we identified a prevalence of overweight and obesity of 25.2% among 254 young patients <30 years (median: 13 years;range: 0-30 years) with severe haemophilia A and without a history of inhibitors. The median FVIII dosage based on bodyweight was significantly higher in normal weight compared with overweight or obese patients (96.9 vs. 72.9 IU/kg/week, respectively;p < 0.0001). This suggests that an individualized dosing regime which might be based on FVIII pharmacokinetics, physical activity and pre-existing haemophilic arthropathy is applied rather than dosing by bodyweight only. The bleeding rates observed in obese (median: 1;range: 0-17) versus normal weight patients (median: 2;range: 0-28) did not differ significantly ( p = 0.057). Lower bleeding rates might be due to reduced activity or expected higher FVIII plasma levels in overweight patients. Due to the increasing prevalence of overweight/obesity in patients with haemophilia an interdisciplinary approach for individualized haemophilia treatment and weight loss programmes might be helpful for optimal and economical treatment for this group of patients.

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