A reconstitutional question
By Rich Gorman
Factor replacement therapies have been revolutionary for people with haemophilia. The ability to treat at home – or even on the go – has given members of our community a level of freedom that earlier generations sadly never had.
These treatments do still require quite a bit of technical know-how, training, and time to prepare and administer though. Whilst for some people with haemophilia this might become second nature, for others the complex and time-consuming nature of preparing treatment can be a major barrier. As a result, many pharmaceutical companies have taken steps to try and make life easier for people with haemophilia, reducing the number of steps and components required and introducing innovative bits of equipment like pre-filled syringes or specialised vial adapters.
Experience and preference
Jon Ulrich Hansen and his colleagues set out to explore the experiences and preferences of people with haemophilia (and their caregivers) about using different ‘reconstitution devices’. They wanted to understand what was important to people with haemophilia and see if they could identify any unmet needs. A recently published paper in The Journal of Haemophilia Practice reports their findings.
The research team interviewed over 100 people. People with haemophilia explained to the researchers the importance of having confidence in using a treatment preparation system, as well as its convenience, portability, and ease of use – though the highest ranked feature was having a low contamination risk. Given the histories of haemophilia, it’s perhaps unsurprising that this remains such an important priority within our community. Other people reflected on a desire for less waste out of their treatment kits – and it’s certainly interesting to think about how environmental values and concerns intersect with haemophilia!
Jon and his colleagues compared two types of treatment mixing systems specifically: the MixPro® and Mix2Vial® devices. The key difference here is that MixPro® uses a pre-filled syringe instead of a separate vial like Mix2Vial®. Overall, they found that people with haemophilia (and care givers) rated the MixPro® system higher and noted a preference for this version of treatment mixing system. It’s perhaps worth noting, though, that the MixPro® system is made by the company that Jon and his colleagues work for. It would be great to see a wider variety of different devices and kits compared in future research.
Convenience and choice
It’s important that the kits and technologies people with haemophilia use to prepare and administer their treatment are quick, convenient, and simple. Putting a treatment together shouldn’t be a barrier for people with haemophilia. If someone is put off doing their treatment due to the hassle involved in mixing a treatment, then that’s a huge failure on the part of manufacturers. It’s great to see innovation taking place here. Many of us will remember far-clunkier kits than what we all use today, with multiple additional transfer needles involved!
People with haemophilia increasingly have more input into the treatments they take. As the landscape and marketplace of treatments continues to expand, the convenience of treatment preparation kits might become something that helps people make a choice about their treatment options, so hopefully innovation will continue to take place.
Further reading
Hansen JU, Percier C, Damgaard-Rasmussen H, Palmer K. Comparative evaluation and preference of MixPro® versus Mix2Vial® reconstitution devices among people with haemophilia and caregivers. J Haem Pract 2022; 9(1): 103-117. doi: 10.2478/jhp-2022-0012
About the author
Rich Gorman lives with severe haemophilia A. He works as a researcher at Brighton and Sussex Medical School.
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