Review Article

Evaluating the Predictive Value of Activated Partial Thromboplastin Time Test in Monitoring Factor VIII Therapy in Hemophilia A Patients

Abstract

Hemophilia A is the most common hereditary coagulation disorder, resulting from a deficiency of clotting Factor VIII, which increases the risk of excessive bleeding and bruising. As an inclusive treatment, Factor VIII replacement therapy is given in the management of Hemophilia A. Prophylaxis has become the primary treatment, focusing on maintaining a baseline Factor VIII level to proactively prevent bleeding episodes. While this therapy has significantly improved patient outcomes, a major challenge remains in determining its efficiency over time. Factor VIII levels tend to decline unpredictably. The standard method for monitoring Factor VIII levels involves Factor assay, but the high cost and limited availability make routine use impractical, especially in resource-limited settings. This uncertainty in monitoring therapy effectiveness leaves patients vulnerable to spontaneous bleeding episodes and complicates clinical decision-making regarding optimal dosing intervals. Given this challenge, an alternative, cost-effective method is necessary to predict the efficiency of Factor VIII replacement therapy. This review aimed to explore the potential use of the activated partial thromboplastin time test (aPTT) as a predictive marker for Factor VIII decay. By establishing a correlation between aPTT and Factor VIII levels, a practical and accessible diagnostic approach can be developed to optimize treatment regimens. Additionally, this review aimed to assess the ability of aPTT to predict Factor VIII levels in Hemophilia A patients, emphasizing the significance of diagnostic strategies in enhancing patient outcomes and ensuring more efficient use of therapeutic resources.