When analysed by bleeding aetiology and/or type, statistically significant differences between on-demand and prophylaxis regimens were observed for spontaneous (P = 0.0008), traumatic (P = 0.0199), joint (P = 0.0006), and non-joint (P = 0.0227) bleeding episodes, as well as spontaneous-joint (P = 0.0013), spontaneous-non-joint (P = 0.0030) and traumatic-joint bleeding episodes (P = 0.0254).
Importantly, the decision to evaluate the incidence of reinterventions for bleeding episodes, as opposed to only bleeding episodes, allowed us to summarise the effect of clinically significant bleeding events with greater fidelity.
Five out of 10 patients (50%) with ALD had major bleeding episodes, as opposed to four out of 24 patients without episodes (16.7%) (P = 0.04).
Research has also included investigation into physiological issues such as seasonality and weather in haemophilia bleeding episodes 4– 10.
Episodes such as this have made pharmaceutical companies wary.
As compared to bleeding episodes, thromboembolism rarely occurred in the present study; also, there was no fatality due to thrombotic failure of the extracorporeal lung support device.
Clopidogrel-treated patients experienced an excess of 83 major bleeding episodes not related to stroke, including 62 episodes classified as severe and an excess of 13 fatal episodes.
The frequency of bleeding episodes over the 3 years preceding enrolment was categorized as: ≥1 bleed/week; 2 3 bleeds/month; 7 12 bleeds/year; 4 6 bleeds/year; 1 3 bleeds/year or <1 bleed/year.
The other clinical indications (such as acute thrombosis or thromboembolism, prevention of DIC in hepatic coma, and treatment of bleeding episodes in cirrhosis) are supported by a small series of very preliminary studies (see, for example, the Drugdex databank, CD-ROM Drugdex, volume 110; Micromedex, Englewood, Colorado, USA).
Bleeding episodes associated with bortezomib-induced thrombocytopenia were infrequent, but can occur as a complication of therapy, albeit rarely.
