Simplifying Therapy for Hemophilia A and Hemophilia BDiplomat Specialty Infusion Group combines clinical expertise with personalized care.
Hemophilia is a rare bleeding disorder. It’s usually inherited. People with hemophilia don’t have enough clotting factor proteins. That means their blood doesn’t clot as it should. This can lead to heavy bleeding after injuries — often inside the body. Sometimes, this bleeding can be life-threatening.
Hemophilia affects about one in 7,500 males. It’s rare in females. That’s because hemophilia is caused by an issue with a gene on the X chromosome. Males only have one X chromosome. Healthy females have two, and it’s unlikely for both to have the faulty gene.
People with severe hemophilia are usually diagnosed as infants. Mild or moderate hemophilia might not be diagnosed until later in life.
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What are the types and levels of hemophilia?
Hemophilia is classified into type A and type B:
- Type A hemophilia is more common — about 80% of cases. People with Type A don’t have enough clotting factor VIII (F8).
- Type B hemophilia is less common — about 20% of cases. People with Type B don’t have enough clotting factor IX (F9).
Hemophilia is also classified by how much clotting factor is in the blood. The three severity levels are:
- Mild (5–40% of normal clotting factor)
- Moderate (1–less than 5%)
- Severe (less than 1%)
About half of people with hemophilia A have the severe form. It affects about a third of people with hemophilia B.
What are the symptoms of hemophilia?
Patients who have hemophilia might notice:
- Heavy bleeding outside the body, especially from the nose or mouth
- Symptoms of bleeding inside the body: large bruises; blood in the urine or stool; or swollen, painful joints
- Symptoms of bleeding in the brain: long and painful headaches, stiff neck, sleepiness, vomiting, double vision, convulsions, seizures, or problems moving the arms and legs
Your symptoms can be more or less severe than your level of hemophilia might imply. Even if your hemophilia is considered mild — based on how much clotting factor is in your blood — your symptoms can be severe.
What can I do to manage my hemophilia?
You can take steps to help manage hemophilia:
- Follow your treatment plan and see your doctor regularly.
- Tell medical and health personnel that you have hemophilia. This includes your healthcare providers, dentist, medical staff at your workplace, and coaches or gym trainers.
- Keep a record of your treatments. Take it with you to medical appointments.
- Stay alert for symptoms of bleeding. Call your doctor or go to the emergency room if you have heavy bleeding from a wound, bleeding you can’t stop, joint pain or swelling, or any signs of bleeding in the brain.
- Avoid sports that could cause bleeding. Walking, swimming, biking, and golf are usually safe.
- Wear a medical alert bracelet or necklace to inform emergency personnel about your condition.
- Be careful with medications that can cause bleeding. These include aspirin, ibuprofen, and naproxen. Follow your doctor’s directions on which medications to take.
How does Diplomat help people who have hemophilia?
Diplomat provides treatment and support according to your doctor’s prescription for your level of hemophilia:
- If you have mild hemophilia, your doctor will usually prescribe desmopressin, also called DDAVP. It’s a hormone that helps your body release stored clotting factor.
- For moderate hemophilia, you might be prescribed factor replacement therapy. This means a concentrate of the needed clotting factor will be infused — put into a vein. This therapy might be conducted regularly or just as needed to stop bleeding. Doctors might also prescribe Hemlibra (emicizumab-kxwh) for hemophilia A, with or without an inhibitor. Hemlibra is a newer type of treatment that’s infused subcutaneously to prevent bleeding.
- Severe hemophilia can be treated with regular factor replacement therapy. Doctors might also prescribe Hemlibra (emicizumab-kxwh) for hemophilia A, with or without an inhibitor.
Treatment for hemophilia can also include:
- Antifibrinolytic medications that help keep blood clots from breaking down. These are often used for mild bleeding or to prepare for dental work.
- Pain medications or steroids
- Physical therapy
Many hemophilia patients choose to infuse themselves at home. This can mean quicker treatment, less time at your doctor’s office, and lower cost. Your doctor can tell you more about home infusion. You can also contact us to learn more.
What are hemophilia treatment centers (HTCs), and how do they help?
There are more than 100 hemophilia treatment centers (HTCs) in the United States. They support, educate, and treat patients and their families. HTCs are staffed by doctors, nurse coordinators, dentists, physical therapists, social workers, and others who specialize in blood disorders.
What are hemophilia inhibitors?
Some patients with hemophilia will develop inhibitors. These antibodies cause your body to reject the blood factors used in treatment. This happens in up to 20% of patients with severe hemophilia A and up to 5% of patients with hemophilia B. Inhibitors often appear during the first year of treatment.
Inhibitors make hemophilia more costly and difficult to treat. Patients with inhibitors can also develop multi-joint arthropathy — joint damage from abnormal bleeding.
There are four standard types of treatment for inhibitors:
- High doses of clotting factor concentrates
- Bypassing agents, which “bypass” inhibitors to help form blood clots
- Immune tolerance induction (ITI) therapy, which uses high levels of clotting factor concentrates over a long period to overwhelm the inhibitor response. This works in about 80% of cases, but treatment might continue for years after the inhibitors go away.
- Hemlibra (emicizumab-kxwh), a bispecific monoclonal antibody, has been approved to treat inhibitors in hemophilia A. It works by “bridging” factors IXa and X to form a clot. This therapy is administered subcutaneously. It is not factor replacement therapy; it is given instead of clotting factor. If a patient has bleeding episodes while taking this medication, a healthcare provider should be notified before giving any factor treatment.
A hemophilia treatment center (HTC) is recommended for inhibitor treatment.
Diplomat supports treatment for hemophilia inhibitors in many ways:
Remember: The information here — and on linked sites — is not meant to replace advice, care, or a diagnosis from your physician. If you have questions about your condition, please ask your provider.
The information contained herein may not be construed as medical advice. It is for educational purposes only. Diplomat Pharmacy Inc. takes no responsibility for the accuracy or validity of the information contained herein, nor the claims or statements of any manufacturer.
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Upcoming TreatmentsWe keep you informed about new specialty medications.
Diplomat actively monitors specialty medications in the government's review and approval process. You can search our database to see if there will be new treatment options for your condition you can discuss with your doctor.
ResourcesDiplomat connects you with the support you need.
We do much more than just fill your prescriptions. Diplomat Specialty Infusion Group provides a number of resources to support you throughout treatment.
The Optum StrapWrap®
A medical-alert wrap
Nate Books: I Am Nate!
A Book for Children on the Basics of Hemophilia
Nate Books: The Great Inhibinator
A Book for Children With Hemophilia & Inhibitors
Nate Books: It’s Always About Nate
A Book for Siblings of Children With a Bleeding Disorder
Kids’ Hemophilia Calendar Contest
Submit Artwork to Be Featured in Diplomat's Annual Calendar
Hemophilia of North Carolina Educational Scholarship Program
A Scholarship for People With Bleeding Disorders
Bleeding Disorder Workshops
Build relationships, promote outreach, provide education to the community, and inspire all
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ProgramsDiplomat’s condition-specific programs provide personalized support.
Diplomat Specialty Infusion Group’s condition-specific programs are great tools to keep you on track throughout therapy. We connect you with condition education, clinical support, treatment coaching, and more.
Financial AssistanceWe’ll look for ways to help you afford therapy.
There are many ways to get help paying for specialty medications. We'll seek third-party programs and support the application process from start to finish.
MyFactor® Infusion AppAn App for People With Hemophilia & Bleeding Disorders
The MyFactor app gives you an easy way to track your bleeding events and treatments and share information directly with your doctor. The app helps patients conveniently track their personal infusion records, bleeding event history, and share important injury and treatment information with members of their healthcare team. MyFactor was tested extensively by members of the hemophilia patient community.LEARN MORE