Factor Replacement Therapy in Delhi

Factor replacement therapy is a life-changing treatment for patients with haemophilia and other bleeding disorders. This specialised therapy replaces missing clotting factors, helping your blood clot normally and preventing dangerous bleeding episodes that can affect your joints, muscles, and vital organs.

Under the expert care of Dr. Satyendra Katewa, patients receive comprehensive factor replacement therapy with personalised treatment plans, ensuring the best possible quality of life and preventing long-term complications.

What Is Factor Replacement Therapy?

Factor replacement therapy provides concentrated clotting factors to patients whose bodies don’t produce enough naturally. Clotting factors are special proteins in your blood that work together to form clots and stop bleeding when you’re injured.

When these factors are missing or low, as in haemophilia or other bleeding disorders, you may experience prolonged bleeding after injuries, spontaneous internal bleeding, and joint damage. Factor replacement therapy corrects this by providing the missing factors through an intravenous infusion (a drip into your vein).

Understanding Haemophilia and Factor Deficiencies

Haemophilia and factor deficiencies are blood disorders that affect the body’s ability to clot properly.

Haemophilia A (Factor VIII Deficiency)

Haemophilia A is the most common inherited bleeding disorder, affecting about 1 in 5,000 male births. People with haemophilia A lack sufficient factor VIII, a critical clotting protein. The severity ranges from:

• Mild: 5-40% of normal factor levels
• Moderate: 1-5% of normal levels
• Severe: Less than 1% of normal levels

Haemophilia B (Factor IX Deficiency)

Also called Christmas disease, haemophilia B results from low levels of factor IX. Though less common than haemophilia A (affecting about 1 in 30,000 males), it requires similar treatment.

Other Factor Deficiencies

Rare clotting factor deficiencies, including factors VII, X, XI, and XIII, also need specialised treatment. These conditions can affect both males and females.

Von Willebrand Disease

The most common inherited bleeding disorder affects von Willebrand factor, which helps platelets stick together and protects factor VIII. Treatment may include von Willebrand factor concentrates or medications that boost your body’s own production of von Willebrand factor.

How Factor Replacement Therapy Works?

Factor replacement therapy delivers concentrated clotting factors directly into your bloodstream, where they immediately help your blood clot properly. Here’s what happens:

1. Intravenous infusion: Purified clotting factors are infused through a vein, usually in your arm or through a port for frequent treatments
2. Rapid distribution: The factors circulate throughout your body, reaching all blood vessels
3. Clotting support: The replacement factors join your body’s natural clotting system, helping form stable blood clots when bleeding occurs
4. Time-limited effect: Factor VIII lasts about 12 hours, factor IX about 18-24 hours, so regular infusions maintain protective levels
5. Prevention and treatment: You can receive factor replacement on demand to treat active bleeding or regularly to prevent bleeding episodes

By replacing missing clotting factors, factor replacement therapy helps prevent bleeding episodes and allows patients to lead safer, healthier lives.

Types of Factor Replacement Products

Different factor replacement therapies are used depending on the type and severity of the clotting deficiency.

Recombinant Factor Concentrates

Modern biotechnology produces clotting factors in laboratory cell cultures without using human blood. These eliminate the risk of blood-borne infections and represent the gold standard in treatment. Options include standard- and extended-half-life products that require less frequent dosing.

Plasma-Derived Factor Concentrates

Purified from donated human plasma through advanced processes. These contain the necessary clotting factors, as well as other plasma proteins that may provide additional benefits.

Extended Half-Life Products

Newer concentrates are designed to last longer in your bloodstream, reducing the frequency of infusions. Extended half-life factor VIII products last 1.5-2 times longer, whilst factor IX can last 3-5 times longer than standard products.

Bypassing Agents

For patients who develop inhibitors (antibodies against replacement factors), bypassing agents provide clotting through alternative pathways.

Emicizumab

A revolutionary medication for haemophilia A that mimics factor VIII function. Given weekly, fortnightly, or monthly by injection under the skin, it has transformed treatment, especially for patients with inhibitors.

Tailoring therapy to each patient’s needs helps prevent bleeding episodes and promotes overall well-being.

When Is Factor Replacement Therapy Needed?

Factor replacement becomes essential whenever the body cannot produce enough clotting factors on its own.

Factor replacement becomes necessary whenever the body cannot produce enough clotting factors on its own.

Treating Active Bleeding

Factor replacement is given immediately when bleeding occurs:

• Joint bleeds cause pain and swelling
• Muscle bleeds, creating large bruises
• Mouth, nose, or gum bleeding
• Head injuries requiring urgent treatment
• Internal bleeding
• Any significant trauma or injury

Early therapy within 2 hours prevents joint damage and speeds recovery.

Prophylactic Treatment (Prevention)

Regular preventive infusions stop bleeding episodes before they start. This approach, now considered standard care for severe haemophilia, dramatically reduces bleeding and prevents joint disease.

Primary prophylaxisstarts in early childhood (typically ages 1-2) before joint damage occurs, providing the best long-term outcomes.

Secondary prophylaxisbegins after some joint bleeds but before significant joint damage develops.

Tertiary prophylaxisbegins after joint damage has occurred to prevent further deterioration.

Before Surgery or Dental Procedures

Any surgical or dental procedure requires factor replacement to prevent excessive bleeding. Factor levels must be raised adequately, with continued replacement afterwards until healing is complete.

During Pregnancy and Delivery

Women with bleeding disorders may need factor replacement during pregnancy complications, delivery, or the postpartum period when bleeding risk increases.

Administering factor replacement at the right time keeps patients safe and helps maintain normal blood clotting.

Comprehensive Diagnostic Evaluation Before Treatment

Proper diagnosis ensures appropriate selection and dosing of factor replacement therapy.

Initial Diagnostic Tests

Coagulation Screening Tests: PT (prothrombin time) and aPTT (activated partial thromboplastin time) identify clotting abnormalities and guide further testing.

Specific Factor Assays: Measure individual clotting factor levels to identify which factor is deficient and the severity of the deficiency.

Von Willebrand Testing: Includes von Willebrand antigen, activity (ristocetin cofactor), and multimer analysis for complete evaluation.

Genetic Testing: Identifies specific mutations that cause haemophilia, helping with family planning and predicting disease severity.

Inhibitor Screening: Tests for antibodies against clotting factors, which develop in 25-30% of patients with severe haemophilia A and require alternative treatment approaches.

Ongoing Monitoring Tests

Pharmacokinetic Studies: Determine how individual patients metabolise infused factors, enabling personalised dosing schedules.

Inhibitor Surveillance: Regular testing (every 3-6 months in young patients) detects inhibitor development early, when immune tolerance therapy is most effective.

Joint Assessment: Physical examination and imaging (ultrasound or MRI) assess joint health and guide adjustments to prophylaxis.

Functional Assessment: Activity scales and quality-of-life measures evaluate treatment effectiveness and guide therapy optimisation.

Dr. Katewa’s comprehensive evaluation ensures an accurate diagnosis and optimal planning for factor replacement therapy.

Step-by-Step Factor Replacement Therapy Process

Factor replacement is administered through a structured process, helping patients receive the correct dose at the right time.

1. Diagnosis and Planning

Your doctor will conduct thorough testing, including:

• Coagulation screening tests to identify clotting abnormalities
• Specific factor assays to measure individual clotting factor levels
• Genetic testing to identify mutations causing haemophilia
• Inhibitor screening to check for antibodies against clotting factors

2. Treatment Planning and Education

You’ll receive:

• Detailed discussion of your diagnosis and treatment options
• Home therapy training so you can give infusions at home
• Emergency protocols for recognising severe bleeds
• Help choosing the right factor product for your needs

3. Factor Infusion Administration

Venous access: For regular treatment, young children may have surgically placed ports. As children grow, they learn to use peripheral veins in their arms.

Product preparation: Factor concentrates are mixed according to instructions, ensuring proper temperature and mixing.

Dose calculation: Precise dosing based on your weight, target factor level, and clinical situation.

Infusion: Factors are infused slowly over 5-10 minutes whilst you’re monitored for any reactions.

Documentation: Every infusion is recorded with date, time, dose, reason, and any side effects.

4. Ongoing Monitoring

Your treatment team will track:

• Bleeding symptoms and joint health
• Factor levels after infusion to confirm adequate dosing
• Bleeding frequency to optimise your schedule
• Quality of life and ability to participate in activities
• Regular inhibitor screening to detect antibodies early

Treatment for Haemophilia A vs Haemophilia B

Whilst both conditions need factor replacement, there are key differences:

Haemophilia A (Factor VIII)

• Shorter half-life (~12 hours) requires more frequent dosing
• Standard prophylaxis is typically administered three times weekly
• Extended half-life products allow twice-weekly dosing
• Higher inhibitor risk (25-30% in severe cases)

Haemophilia B (Factor IX)

• Longer half-life (18-24 hours) needs less frequent dosing
• Standard prophylaxis is typically administered twice weekly
• Extended half-life products enable weekly or fortnightly dosing
• Lower inhibitor risk (3-5% in severe cases)

Managing Side Effects

Most patients tolerate factor replacement excellently, but potential side effects include:

Common Side Effects

• Mild redness or discomfort at needle insertion sites
• Occasional headaches during or after infusions
• Brief metallic taste during infusion
• Rare nausea, usually managed by slowing the infusion

Serious Complications

Inhibitor development: The most significant complication is when your immune system produces antibodies against infused factors, making treatment ineffective. Requires specialised management with bypassing agents or immune tolerance therapy.

Allergic reactions: Rare responses ranging from mild itching to severe allergic reactions.

Catheter-related infections: Central venous catheters carry infection risks, requiring careful maintenance and monitoring.

Dr Katewa’s approach includes careful product selection, proper infusion techniques, regular inhibitor screening, and prompt management of any complications.

Factor Replacement Therapy Cost in Delhi

Haemophilia treatment in India has become more accessible with improved availability of factors, though costs remain significant.

Factor Concentrate Costs

Standard Half-Life Factor VIII:₹3,000-6,000 (USD 36 – USD 72) per 500 IU vial

Extended Half-Life Factor VIII:₹4,000-8,000 (USD 48 – USD 96) per 500 IU vial

Standard Half-Life Factor IX:₹4,000-7,000 ( USD 48 – USD 85) per 500 IU vial

Extended Half-Life Factor IX:₹5,000-10,000 (USD 60 – USD 120) per 500 IU vial

Annual Treatment Costs

On-Demand Treatment:₹3,00,000-8,00,000 (USD 3,600 – USD 9,600) annually (varies with bleeding frequency)

Prophylaxis Treatment:₹10,00,000-25,00,000 (USD 12,000 – USD 30,000 )annually for standard products

Extended Half-Life Prophylaxis:₹8,00,000-20,00,000 (USD 9,600 – USD 24,000) annually (lower due to reduced frequency)

Benefits of Factor Replacement Therapy

These are the benefits of factor replacement therapy, which help patients lead safer, more active lives.

Prevents Joint Damage

Regular prophylaxis prevents chronic joint disease from repeated bleeds, preserving mobility and function throughout life.

Enables Normal Activities

Adequate factor levels allow participation in school, sports, work, and recreational activities with minimal risk of bleeding.

Improves Quality of Life

Freedom from frequent painful bleeds and hospital visits dramatically enhances daily living and emotional well-being.

Extends Lifespan

Modern factor replacement therapy enables near-normal life expectancy, compared to just 10-20 years before treatment was available.

Prevents Disability

Early prophylaxis prevents the severe joint deformities and disability that affected haemophilia patients in previous generations.

Empowers Independence

Home treatment allows a rapid bleeding response and independence from hospitals for routine care.

Long-Term Haemophilia Management

Successful haemophilia care extends beyond factor infusions to comprehensive lifelong management:

Regular Monitoring

• Clinical assessments every 6-12 months, tracking joint health and treatment effectiveness
• Annual laboratory testing, including inhibitor screening
• Joint evaluations to detect early damage
• Quality of life assessments

Physical Therapy

Specialised haemophilia physiotherapy strengthens muscles supporting joints, improves flexibility, and helps rehabilitation after bleeds. Regular exercise programmes reduce bleeding frequency and maintain function.

Dental Care

Preventive dental care minimises procedures requiring factor coverage. When dental work is needed, coordination with your haemophilia team ensures adequate factor replacement.

Genetic Counselling

Families receive education about inheritance patterns, carrier testing, prenatal diagnosis options, and family planning considerations.

Psychosocial Support

Living with haemophilia affects emotional health, family dynamics, school or work participation, and relationships. Counselling and support groups address these challenges.

Why Choose Dr Satyendra Katewa for Haemophilia Treatment?

These are the key factors that make Dr. Satyendra Katewa the preferred specialist for haemophilia care.

Specialised Expertise

Dr Satyendra Katewa is recognised as a leading specialist for haemophilia treatment, with extensive experience managing complex bleeding disorders in children and adults.

Comprehensive Care

Integration of factor replacement therapy with physiotherapy, genetic counselling, surgical coordination, and psychosocial support provides holistic treatment.

Paediatric Haemophilia Specialisation

Specialised paediatric haemophilia treatment includes age-appropriate education, family training, school coordination, and developmental monitoring, ensuring optimal childhood outcomes.

Home Therapy Programmes

Comprehensive home infusion training empowers families with skills for safe home treatment, enabling rapid bleeding response and improved quality of life.

Access to Advanced Products

Availability of extended half-life factors, bypassing agents, and novel therapies like emicizumab provides patients with cutting-edge treatment options.

Inhibitor Management Expertise

Specialised protocols for inhibitor patients, including bypassing agent therapy and immune tolerance induction, achieve optimal outcomes for this challenging complication.

Multidisciplinary Team Approach

Collaboration with orthopaedic surgeons, physiotherapists, dentists, and other specialists ensures coordinated, comprehensive care.

Families trust Dr Katewa for his clinical excellence, compassionate care, and commitment to achieving the best possible outcomes for every haemophilia patient.

Book an Appointment

If your child or loved one has haemophilia or another bleeding disorder requiring factor replacement therapy, consult Dr Satyendra Katewa for expert evaluation and comprehensive treatment planning.

During your consultation, you’ll receive:

• Complete bleeding disorder assessment and diagnosis confirmation
• Detailed explanation of factor replacement therapy options
• Personalised treatment plan with prophylaxis recommendations
• Home therapy training for family members
• Long-term management strategy for optimal outcomes

Book your appointment today to begin comprehensive haemophilia care with a leading paediatric haemato-oncologist.

International Patients

Dr Satyendra Katewa welcomes international patients seeking expert haemophilia treatment. Support includes:

• Medical visa facilitation and documentation
• Factor product availability confirmation
• Home therapy training and supply arrangements
• Accommodation recommendations
• Clear cost estimates
• Coordination with home country haemophilia teams
• Follow-up care through telemedicine after returning home

Contact us to discuss your bleeding disorder treatment needs and care coordination.