ArticleFrontiers in medicine2026
Pharmacokinetic-guided versus weight-guided coagulation factor replacement in hemophilia patients undergoing arthroplasty: a retrospective real-world study on perioperative bleeding risk and economic outcomes.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study aimed to compare the perioperative bleeding risk and economic outcomes of pharmacokinetic (PK)-guided versus weight-guided coagulation factor replacement regimens during the perioperative period for patients with hemophilia undergoing joint arthroplasty. Method: We conducted a retrospective analysis of clinical data from patients with hemophilia who underwent knee or hip joint arthroplasty at our center between 2013 and 2025. Results: Thirty-three male patients with a median age of 39 years were included. Twenty-five patients (75.8%) had severe hemophilia. Seventeen patients (51.5%) underwent total joint arthroplasty, and 16 (48.5%) underwent partial joint arthroplasty. Perioperative coagulation factor replacement was weight-guided in 22 patients (66.7%) and PK-guided in 11 patients (33.3%). Postoperative SF-6Dv2 scores indicated a significant improvement in quality of life compared to preoperative baselines. The PK-guided group demonstrated a significantly lower median hospitalization cost (138,232 RMB vs. 200,122 RMB, Conclusion: For patients with hemophilia undergoing joint arthroplasty, a PK-guided coagulation factor infusion regimen significantly reduced factor consumption and overall medical costs, without a statistically significant increase in perioperative bleeding risk compared with the weight-guided approach. These exploratory findings support the clinical and economic advantages of PK-guided management in this surgical setting and warrant confirmation in larger, prospective studies.
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