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maria o secundaria con FVIII. La profilaxis secundaria continua
a largo plazo es también recomendada con artropatía establecida
para prevenir la recurrencia de eventos hemorrágicos, el desarrollo
de articulaciones dianas o para enlentecer la progresión de un del
daño articular ya establecido. En cuanto a una profilaxis a corto
plazo (3-6 meses) el panel considera que debería considerarse en
pacientes que precisen fisioterapia activa o prolongada y en pacien-
tes mayores con articulaciones diana antes de actividades de riesgo
para la aparición de sangrados.
Existe un interés cada vez mayor en la profilaxis en pacien-
tes con inhibidor. Sin embargo, su uso continúa siendo limitado
probablemente en relación con múltiples factores, como la menor
eficacia de los agentes baipás comparada con el FVIII, los incon-
venientes relacionados con su administración (vida media corta del
rFVIIa o tiempo de infusión de CCPa), el coste de un tratamiento
de este tipo a largo plazo o el riesgo asociado de fenómenos trom-
bóticos, especialmente en pacientes de cierta edad.
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