Treatment and Therapies for Hemophilia C
If you are having surgery or have been injured, your hematologist may choose to treat your bleeding with antifibrinolytics, such as aminocaproic acid tranexamic acid, fresh frozen plasma, or concentrated FXI (not currently available in the United States). Antifibrinolytics are especially helpful for bleeding from the mucous membranes, such as mouth bleeds or menorrhagia and may be sufficient for dental procedures. Menorrhagia may also be managed with birth control pills, IUDs, injected contraceptives, or antifibrinolytics. Fibrin glue (which is made of clotting proteins and thrombin) may be useful, especially at the site of a surgery. Some treatment options have side effects, such as excessive clotting (rare) or an allergic reaction, so developing a specific treatment plan with your hematologist that includes monitoring and follow-up is a good idea.
Inhibitors for Hemophilia C
Inhibitors are autoantibodies (specialized proteins produced by the body’s immune system that target healthy tissue). If you have hemophilia C, you can develop an inhibitor, which can impact the effectiveness of your treatment. The inhibitor is usually found when breakthrough bleeding (bleeding once treatment has begun) or a worsening response to FXI rather than spontaneous bleeding. If you develop an inhibitor, your hematologist will likely recommend additional therapy, such as FVII. FVII has been used to treat bleeding episodes after surgery, but its use is still in the investigative stages. Current findings are that lower doses combined with antifibrinolytics are effective, but higher doses may cause excessive clotting.