Treatment of haemophilia patients in East Germany prior to and after reunification in 1990

摘要

The reunification of Germany in 1990 brought with it major challenges in terms of unifying the care offered to haemophilia patients. At that time, most of the treatment centres belonged to the largest regional hospitals. The centre for paediatric haemophilia patients in Leipzig was at the University Hospital. In this centre, early prophylaxis was offered to all patients with severe haemophilia A or B. For over 20 years, the treatments of choice in the German Democratic Republic were cryoprecipitate for haemophilia A and prothrombin complex concentrate for haemophilia B. Cryoprecipitate was relatively effective during minor surgery, in cases of mild to moderate bleeding, and for prophylaxis; however, unpleasant, relevant side-effects and hepatitis virus transmission were frequently encountered in clinical practice. Reunification coincided with the availability of virus-safe, high-purity plasma-derived factor VIII concentrates (e.g. Beriate~R P), which changed the outlook for patients in terms of convenience, tolerability, and virus safety; and these new products quickly became the treatments of choice for haemophilia A patients at the Leipzig Children's Hospital. Today, 20 years later, nearly all of the patients initiated on Beriate~R P at the time of reunification continue with that treatment, and are still benefitting from its excellent efficacy, tolerability, and virus-safety profile.