Types of prophylaxis

Unlike episodic or “on demand” treatment, which is given at the time of a bleed to make it stop, prophylaxis is given to prevent bleeding before it starts.

There are several types of prophylaxis. Continuous prophylaxis (primary, secondary, and tertiary) is given regularly over a period of several months and often years. Intermittent or periodic prophylaxis is given for shorter periods of time, usually a few weeks or months.

Type of TreatmentDefinition
Episodic (“on demand”) treatment Treatment given at the time of bleeding.
Continuous prophylaxis
Primary prophylaxis
Regular continuous treatment, started before the second large joint bleed and age of 3 years.
Secondary prophylaxis Regular continuous treatment started after 2 or more large joint bleeds but before the onset of joint disease.
Tertiary prophylaxis Regular continuous treatment started after the onset of joint disease to prevent further damage.
Intermittent (“periodic”) prophylaxis Treatment given to prevent bleeding for short periods of time, such as during and after surgery.

Adapted from: Guidelines for the Management of Hemophilia, World Federation of Hemophilia, 2012.

Note: These definitions are consistent with those published by the Factor VIII & IX Scientific Standardization Committee of the International Society on Thrombosis and Haemostasis. National or regional programs may rely on other definitions.

Updated December 2014


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