The Time Has Come for Greater Efficiency

ČSH

The efficiency of treatment with concentrates, whether plasma-derived or recombinant. The demand for better use of products does not come from developing countries, but from developed ones. Even there, they recognise that the economics of treatment plays an important role and that with the same resources, a better outcome can ultimately be achieved. But it is not just about cost-effectiveness — it is also about greater comfort.

Certain global studies have shown that every organism responds differently to the administration of clotting factors. Some people need a larger dose to achieve a certain level of Factor VIII or IX than others, or conversely, a smaller dose is sufficient for the same effect. The formula of dosing a certain number of IU per kilogram of body weight is no longer sufficient — it is becoming merely a formal guideline.

Professor Collins was the first to point out this fact, and further studies only confirmed his hypothesis. Major world centres have been conducting individual tests for some time to determine what doses each person needs. And also how long the required level is maintained. The practical effect? Part of the concentrates can be redirected from one group to another, concentrate consumption will remain the same — or even decrease — in short, treatment efficiency will increase significantly.

However, the data do not come only from abroad — testing has also begun in our country. Peter Salaj from the Institute of Haematology and Blood Transfusion in Prague, in cooperation with experts from the Faculty of Mathematics and Physics at Charles University, has developed a methodology that will be populated with data from laboratory tests. For their subjects, this means one thing — they must undergo blood sampling at certain time intervals before and after administering the concentrate, and the laboratory tests will produce results. These are then entered into prepared complex tables in Excel — and the result is here.

The entire process takes a few days and serves once and for all. Everyone who participates in the measurement will obtain their own unique overview of how their organism responds, and on that basis, their treatment centre will consider further dosing. It will play the biggest role mainly in prophylaxis, but will also find application in acute treatment.

Some foreign institutions have already begun cooperating with smartphone manufacturers, where the programme will appear and everyone will thus gain an overview of their actual needs. Hopefully the time is not far when such an opportunity will arise here too, and a significant tool for increasing the effectiveness of therapy will be available. And thereby also for more rational use of coagulation factors in both home and hospital treatment.