Severe haemophilia A and B (SHA, SHB) are X - linked inherited bleeding disorders, characterised by factor VIII and IX levels of \<1 IU/dL respectively. The mainstay of treatment in SHA and SHB is replacement therapy with intravenous infusions of factor VIII and IX. However, there is significant variability in the bleeding phenotype within severe haemophiliacs with some presenting with minimal bleeding episodes even on less intensive treatment regimens. A significant contributor to inter-individual variability in the bleeding phenotype is the coagulation phenotype, but there are no established assays in routine clinical practice that can be used to quantify this. This study aims to study novel assays and characterise the observed phenotypic heterogeneity.
Study Type
OBSERVATIONAL
Enrollment
250
Thrombophilia screen (including antithrombin activity (AT:Ac), protein S antigen (PS:free), protein C activity (PC:Ac) , genetic analysis for FV Leiden and Prothrombin 3'UTR mutations and screening for lupus anticoagulant.
Evaluation of inter-individual variability in regulation of TF.VIIa.Xa.TFPI complex (tissue factor, activated Factor VII, activated factor X, tissue factor pathway inhibitor)
Royal Free Hospital
London, United Kingdom
RECRUITINGInitiation pathway correlation with clinical phenotype
Correlate lab assays that characterise initiation pathway with clinical phenotype.
Time frame: Within 18 months of consent
Correlation analysis between FVIII:C/FIX:C levels and whole blood clotting time, thrombin generation in platelet poor plasma.
Time frame: Within 18 months of consent
Evaluation the sensitivity and specificity of global assays for disease severity and clinical phenotype.
Time frame: Within 18 months of consent
Correlation analysis between activation threshold of initiation pathway to thrombin generation and clinical phenotype
Time frame: Within 18 months of consent
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