How Hemophilia B Is Treated

Hemophilia B is the second most common type of hemophilia, a rare genetic blood-clotting disorder that can result in episodes of excessive bleeding. Hemophilia B can be treated with synthetic or plasma-derived replacements for factor IX, a blood-clotting protein that people with this condition are lacking.

Other mainstays of therapy are avoiding injury and promptly treating the bleeding episodes that do occur. Serious bleeding complications may require specific intervention to reduce the risk of harmful effects to your health, such as bleeding into the joints, which can lead to arthritis.

This article will review the lifestyle management strategies and treatment options for hemophilia B.

Home Remedies and Lifestyle

There is no cure for hemophilia B, but it’s possible for you and your family to learn how to prevent injury and administer your own clotting factor treatments at home.

Whether or not you are on home treatment, you should always have replacement clotting factors at home. This is what you will need in case of emergency. After you receive factor treatment, rest, ice, compression, and elevation, also known by its acronym, the RICE method, is required.

In addition, being mindful of the following risk factors may help mitigate your risk of developing severe medical complications:

• Avoiding dangerous or risky situations that may lead to injury
• Avoiding blood thinners, like heparin, Jantoven or Coumadin (warfarin), and Plavix (clopidogrel), as well as medications that worsen bleeding, such as aspirin and Advil or Motrin IB (ibuprofen)
• Practicing good dental hygiene
• Engaging in regular low-impact exercise like swimming and biking, while avoiding contact sports like football and rugby
• Getting vaccinated—and with the smallest needle possible—to protect you from infections

Over-the-Counter (OTC) Therapies

Bleeding into the joints and bruising can be painful. Unfortunately, common OTC pain medications like aspirin and Advil or Motrin IB can interfere with the body’s ability to clot blood. Therefore, you may want to substitute these medications with Tylenol (acetaminophen) for pain relief.

Prescriptions

While there is no cure for hemophilia B, the disease can be treated over the long term with prescription replacements for the clotting factor IX that is missing in children and adults with this condition. Other medications may also be prescribed to help promote blood clotting. Treatments include:

• Clotting factor IX products: An estimated 75% of hemophilia patients are treated with synthetic blood-clotting factors, which are made in a lab. There are also products made from human blood plasma. All of these products can be infused into a vein on a regular schedule to prevent bleeding or given on demand in the case of a bleeding episode:
• The Food and Drug Administration (FDA) has approved the following artificially made factor IX products for hemophilia B: BeneFIX, Rixubis, Ixinity, Idelvion, Rebinyn, and Alprolix. Alprolix is a long-acting product. It may be administered for routine prophylaxis (preventive treatment) once weekly or every 10 days, depending on the severity of your condition.
• There are also two factor IX products available that are made from highly purified human blood plasma: AlphaNine SD and Mononine.
  
• Amicar (aminocaproic acid): This clot-preserving medication is taken by mouth as a pill or liquid to prevent the breakdown of blood clots. It may also be prescribed before surgery or if you have a bleed.
• Fibrant sealants: These are medical-grade glues that can be applied directly over the wound site as they promote clotting and healing for patients with hemophilia.

Specialist-Driven Procedures 

Surgery is not a common treatment for hemophilia B, but sometimes surgery or other treatments such as blood transfusions for heavy blood loss or intravenous administration of FIX may be given at a comprehensive hemophilia treatment center (HTC).

An HTC is a facility consisting of a multidisciplinary team that includes doctors who specialize in the treatment of blood disorders (called hematologists) and physiatrists, who specialized in physical medicine and rehabilitation, as well as nurses, social workers, physical therapists, and other healthcare providers who specialize in the care of people with bleeding disorders. 

Complementary and Alternative Medicine (CAM) 

There are no CAM therapies approved for hemophilia B, and some therapies can put you at greater risk for a bleeding episode. It's important to discuss any CAM treatment you are considering with a hematologist (blood disorder specialist) to make sure that it's safe for your condition.

Hemophilia B can cause bleeding into the joints and muscles, which can cause significant joint pain and swelling. Over time, repeated bleeding in the joints can lead to arthritis.

Some CAM interventions like yoga, moderate exercise (like swimming, biking, and even weight lifting), and physical therapy can help manage the pain and prevent damage from joint bleeding. These activities may also help improve hemophilia patients' quality of life.

Summary

The mainstay treatment for hemophilia B is the prophylactic (preventive) administration of clotting factor IX, but specific treatments depend on the severity of your hemophilia and the need to manage your acute needs at the time. A personalized treatment plan that is tailored to you can alleviate symptoms and lower your risk of complications. Specific treatment for your hemophilia is determined by:

• Your age, overall health, and medical history
• The extent of the disease
• Your tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

A Word From Verywell

Comprehensive treatment of your hemophilia usually requires seeing multiple specialists and other healthcare providers. You and your caregivers should have access to additional information regarding new treatment options, with a specific emphasis on providing personalized health education adapted to the present challenges that you may be facing.