Recommending defunct therapies is a safety risk for hemophilia

Abstract

We believe the article promoting the use of pathogen-reduced cryoprecipitate and untreated cryoprecipitate takes hemophilia care back 60 years, to a time before clotting factor concentrates (CFCs), extended half life CFCs, and Factor VIII mimetic bispecific antibodies were available. All of these classes are used prophylactically to prevent bleeding, whereas cryo is only used reactively, to treat bleeding. On-demand therapy of bleeding results in morbidity in nearly all patients and mortality in some, whereas prophylaxis can prevent or delay bleeding sequelae depending on the class of treatment used. In addition, since pathogen-reduced cryo is only available in 3 countries (including the USA which does not use it for hemophilia), untreated cryoprecipitate may be used and will cause some HIV and hepatitis infections in endemic countries with prolonged use, an unacceptable risk in 2024.