Guy Young, MD, and Miguel A. Escobar, MD, prepared useful practice aids pertaining to hemophilia A for this CME activity titled "Defining the Role of Extended Half-Life Replacement Clotting Factors in the Modern Management of Hemophilia A.” For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2E6L4eD. CME credit will be available until February 24, 2020.

1. This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
Calculating Annual Bleed Rate (ABR)1
a
Work with patient to determine their individual treatment plan.
1. Mullins ES et al. Haemophilia. 2017;23:238-246.
PRACTICE AID
Access the activity, “Defining the Role of Extended Half-Life Replacement Clotting Factors in the Modern
Management of Hemophilia A,” at www.peerview.com/XAQ40.
Bleed Rate
(Count # bleeds
each month)
Notes
(Pain level, trauma,
activity level, etc)
Month 1
Month 2
Month 3
Month 4
Month 5
Month 6
Month 7
Month 8
Month 9
Month 10
Month 11
Month 12
ABR
ABR = sum # of bleeds over 12 months
ABR Goala
:___________________

2. Access the activity, “Defining the Role of Extended Half-Life Replacement Clotting
Factors in the Modern Management of Hemophilia A,” at www.peerview.com/XAQ40.
Extended Half-Life Replacement
Factors for Hemophilia A1-6
This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
ABR: annualized bleeding rate; ED: exposure days; Fc: fragment crystallizable; FVIII: factor VIII; MOA: mechanism of action; rFVIII: recomibinant factor VIII.
1. Peyvandi F et al. J Thromb Haemost. 2013;11(Suppl 1):84-98. 2. Mahlangu J et al. Blood. 2014;123:317-325. 3. Konkle BA et al. Blood. 2015;126:1078-1085. 4. Coyle TE et al. J Thromb Haemost.
2014;12:488-496. 5. Reding MT et al. J Thromb Haemost. 2017;15:411-419. 6. Giangrande P et al. Thromb Haemost. 2017;117:252-261.
PRACTICE AID
Half-Life Extension MOA Clinical Information
Fc Fusion Name: Efmoroctocog alfa
t½ extension over standard rFVIII = 1.5-1.7
ABR ↓ vs on-demand
Name: Rurioctocog alfa pegol
t½ extension over standard rFVIII = 1.4-1.5
ABR ↓ vs on-demand
Name: Damoctocog alfa pegol
t½ extension over standard rFVIII = 1.5
ABR ↓ vs on-demand
Name: Turoctocog alfa pegol
t½extension over standard rFVIII = 1.6
ABR ↓ vs on-demand
ApprovedInvestigational
PEGylation
Individualized
prophylaxis
92%
Weekly
prophylaxis
76%
95%
Twice weekly
prophylaxis
1x/5 days
prophylaxis
92%
1x/4 days
prophylaxis
96%
1
Patient
developed
FVIII inhibitors
after 93 ED
Protein of interest Fc region
Fc region
Protein of
interest
H
H
n
o
o
PEG
PEG
Polyethylene glycol (PEG)

3. This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
Four-Item Morisky Medication
Adherence Scale (MMAS-4)1
1. Adapted from Morisky DE et al. Med Care. 1986;24:67-74.
PRACTICE AID
Access the activity, “Defining the Role of Extended Half-Life Replacement Clotting Factors in the Modern
Management of Hemophilia A,” at www.peerview.com/XAQ40.
Question Answer
1. Do you ever forget to take your medicine? Yes or No
2. Are you careless at times about taking your medicine? Yes or No
3. If you feel better when taking the medicine, do you sometimes stop
taking it?
Yes or No
4. If you feel worse when you take the medicine, do you sometimes stop
taking it?
Yes or No
Score:
Scoring and Interpretation
• No = 0
• Yes = 1
• Items summed to give range of scores from high adherence to low adherence
0 = high adherence
1-2 = medium adherence
3-4 = low adherence

4. This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
Additional Resources
WFH: World Federation of Hemophilia.
PRACTICE AID
Access the activity, “Defining the Role of Extended Half-Life Replacement Clotting Factors in the Modern
Management of Hemophilia A,” at www.peerview.com/XAQ40.
WFH Guidelines for the Management of Hemophilia
http://www.wfh.org/en/resources/wfh-treatment-guidelines
WFH Compendium of Bleeding Assessment Tools
http://www.wfh.org/en/resources/bleeding-assessment-tools
WFH Compendium of Functional and Physical Examination Tools
http://www.wfh.org/en/resources/functional-and-physical-examination-tools