Impact of extreme weight loss on factor VIII concentrate pharmacokinetics in haemophilia. Issue 4 (12th April 2021)

• Record Type: Journal Article
• Authors: van Moort, Iris; Bukkems, Laura H; Nieuwenhuizen, Laurens; Cnossen, Marjon H
• Is Part Of: BMJ case reports. Volume 14:Issue 4(2021)
• Publication Date: 2021-04-12
• Subjects: haematology (drugs and medicines) -- haematology (incl blood transfusion) -- pharmacokinetics; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2020-238036
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : We explored the effects of extreme weight loss after gastric bypass surgery on factor VIII concentrate pharmacokinetic (PK) parameters in a patient with haemophilia A. We present a 32-year-old man with severe haemophilia A, with a body mass index (BMI) of 42.6 kg/m 2 who underwent laparoscopic sleeve gastrectomy. We showed that a population PK model with ideal body weight as morphometric variable instead of bodyweight led to an adequate description of the individual PKs in this patient with a variable BMI. Strikingly, no differences were observed in the individual PK parameters after extreme weight loss. Therefore, the resulting extreme weight loss after surgery did not lead to prophylactic dose changes in this patient with severe haemophilia. We carefully conclude that population PK–pharmacodynamic models are still obligatory to give more insight into functional effects of significant weight loss on the haemostatic balance.