Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions

Record type Uncertainties identified in research recommendations
Source Cochrane Cystic Fibrosis and Genetic Disorders Group
Why is there uncertainty? Reliable up-to-date systematic reviews have revealed important continuing uncertainties about treatment effects

Original Uncertainty

Implications for Research Although the use of antifibrinolytic therapy is part of routine practice to manage oral or dental procedures in many haemophilia treatment centres, this is not supported by high quality data. In order to be conclusive, further research is required on a representative population of patients with congenital bleeding disorders undergoing minor oral or dental procedures with clearly defined patient characteristics, using equal concomitant standard therapy and with a statistically sufficient sample size. Despite the fact that VWD is the most common inherited bleeding disorder, no trials discussing antifibrinolytic therapy in these patients were eligible for inclusion. The effect of antifibrinolytic therapy in this patient group to prevent bleeding after oral or dental procedures requires further research.


References to reliable up-to-date systematic reviews:

van Galen KPM, Engelen ET, Mauser-Bunschoten EP, van Es RJJ, Schutgens REG. Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No.: CD011385. DOI: 10.1002/14651858.CD011385.pub2

What is needed? Further research
Systematic reviews that need updating or extending None identified
Systematic reviews in preparation None identified
Ongoing controlled trials None identified

Classification

Which health conditions? Haematological disorders
What is person's age? Any age
Which types of treatments? Drug

Which Outcomes

Incidence of oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions: or change in management of symptoms (number of bleeds, amount of blood loss, need for therapeutic clotting factor concentrates); adverse effects or complications (incidence of bleeding complications,); patient satisfaction; health related quality of life; service related issues; and health related cost


Record ID: Publication date:10 Mar 2016
Last reviewed date:10 Mar 2017 Publication Type:Known Uncertainty
The DUETs team endeavours to ensure that information is correct at the time of data entry