Impact of extreme weight loss on factor VIII concentrate pharmacokinetics in haemophilia

Iris Van Moort, Laura H. Bukkems, Laurens Nieuwenhuizen, Marjon H. Cnossen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
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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.

Original languageEnglish
Article numbere238036
JournalBMJ Case Reports
Issue number4
Publication statusPublished - 12 Apr 2021

Bibliographical note

Funding: This study is part of the OPTI-CLOT randomized controlled trial which was
kindly funded by a grant from NWO-ZonMw (Netherlands Trial Registry: NL3955),
a governmental research institution and by an unrestricted investigator-initiated
research grant provided by Baxter/Shire/ Baxalta/Takeda.

Publisher Copyright: © 2021 BMJ Publishing Group. All rights reserved.


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