Transitioning from Prophylaxis to Bleed Management: Creating Effective Plans for Hemophilia Patients

Transitioning patients from a prophylactic regimen to a bleeding management protocol requires a structured, individualized approach. Providers must assess the type of prophylaxis, recent bleeding history, and patient-specific risk factors to determine how to rapidly and safely address breakthrough bleeds. A comprehensive bleed management plan, such as those used with fitusiran, should outline clear instructions for recognizing and treating bleeds, recommended therapies, dosing guidelines, and monitoring parameters. The plan is typically developed collaboratively by a multidisciplinary team—including hematologists, pharmacists, nurses, and sometimes physical therapists—with each member providing expertise on therapy selection, administration, monitoring, and patient education. The plan also addresses perioperative care, detailing adjustments to therapy before, during, and after surgery to minimize bleeding risk. Clear communication and patient education ensure timely intervention and optimize outcomes.