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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Terapevticheskii arkhiv</journal-id><journal-title-group><journal-title xml:lang="en">Terapevticheskii arkhiv</journal-title><trans-title-group xml:lang="ru"><trans-title>Терапевтический архив</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0040-3660</issn><issn publication-format="electronic">2309-5342</issn><publisher><publisher-name xml:lang="en">LLC Obyedinennaya Redaktsiya</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">104766</article-id><article-id pub-id-type="doi">10.26442/00403660.2022.01.201321</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Original articles</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Оригинальные статьи</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Unsolved issues of treatment of adult patients with hemophilia A</article-title><trans-title-group xml:lang="ru"><trans-title>Нерешенные вопросы лечения взрослых пациентов с гемофилией А</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7074-0926</contrib-id><name-alternatives><name xml:lang="en"><surname>Zozulya</surname><given-names>Nadezhda I.</given-names></name><name xml:lang="ru"><surname>Зозуля</surname><given-names>Надежда Ивановна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, зав. отд. коагулопатий</p></bio><email>zozulya.n@blood.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6430-1740</contrib-id><name-alternatives><name xml:lang="en"><surname>Dimitrieva</surname><given-names>Oksana S.</given-names></name><name xml:lang="ru"><surname>Димитриева</surname><given-names>Оксана Сергеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>врач-гематолог отд. коагулопатий</p></bio><email>zozulya.n@blood.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">National Research Center for Hematology</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр гематологии» Минздрава России</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2022-01-15" publication-format="electronic"><day>15</day><month>01</month><year>2022</year></pub-date><volume>94</volume><issue>1</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>77</fpage><lpage>82</lpage><history><date date-type="received" iso-8601-date="2022-03-12"><day>12</day><month>03</month><year>2022</year></date><date date-type="accepted" iso-8601-date="2022-03-12"><day>12</day><month>03</month><year>2022</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2022, Consilium Medicum</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2022, ООО "Консилиум Медикум"</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="en">Consilium Medicum</copyright-holder><copyright-holder xml:lang="ru">ООО "Консилиум Медикум"</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-sa/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://ter-arkhiv.ru/0040-3660/article/view/104766">https://ter-arkhiv.ru/0040-3660/article/view/104766</self-uri><abstract xml:lang="en"><p><bold>Background. </bold>Sufficient supply of coagulation factors products has significantly improved life quality and expectancy in patients with hemophilia. Certain difficulties, however, persist when it comes to the treatment of the disease.</p> <p><bold>Aim. </bold>To analyze current therapeutic approaches and identify major unsolved issues in the treatment of patients with hemophilia A.</p> <p><bold>Materials and methods. </bold>An online survey of 100 adult patients with hemophilia A was held.</p> <p><bold>Results. </bold>More than a half of the surveyed sample (59%) are patients aged 19 to 40 with the severe form of the disease, 73% of respondents receive a replacement therapy with plasmatic factors, 42% of patients inject drugs 3 times a week or more. More than a half of all age groups with hemophilia have persistent pain and limited joint mobility, in 70% of the patients, bleeding into the joints occurred 4 or more times within the past year, 47% of the patients with hemophilia A are partially satisfied or dissatisfied with their state of health, 92% of the patients would like to improve their quality of life. At the same time, about 1/3 of the patients would like to reduce the frequency of drug administration. More than 40% of the respondents did not visit a hematologist during the year, 85% do not conduct regular laboratory monitoring.</p> <p><bold>Conclusion.</bold> The survey results demonstrate numerous areas of potential change pertaining to the approaches towards therapy and to the innovative drugs for the treatment of patients with hemophilia.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Обоснование. </bold>Достаточная обеспеченность препаратами факторов свертывания крови позволила существенно повысить качество и увеличить продолжительность жизни пациентов с гемофилией. Однако сохраняются определенные трудности в лечении заболевания.</p> <p><bold>Цель. </bold>Проанализировать текущие терапевтические подходы и выявить основные нерешенные вопросы терапии пациентов с гемофилией А.</p> <p><bold>Материалы и методы. </bold>Проведен онлайн-опрос 100 взрослых пациентов с гемофилией А.</p> <p><bold>Результаты. </bold>Более 1/2 (59%) опрошенной выборки – пациенты в возрасте от 19 до 40 лет с тяжелой формой заболевания, 73% респондентов получают заместительную терапию плазматическими факторами, 42% пациентов вводят препараты 3 раза в неделю и чаще. Более 1/2 пациентов с гемофилией А во всех возрастных группах отмечают сохранение болей и ограничение подвижности суставов, у 70% пациентов частота кровотечений в суставы – 4 раза и более за последний год, 47% пациентов с гемофилией А частично удовлетворены или не удовлетворены своим состоянием здоровья, 92% пациентов хотели бы улучшить качество жизни. При этом около 1/3 пациентов хотели бы уменьшить частоту введения препаратов. Более 40% опрошенных не посещали гематолога в течение года, 85% не проводят регулярный лабораторный мониторинг.</p> <p><bold>Заключение. </bold>Результаты опроса демонстрируют необходимость изменения подходов в терапии и внедрении инновационных препаратов для лечения пациентов с гемофилией.</p></trans-abstract><kwd-group xml:lang="en"><kwd>hemophilia A</kwd><kwd>bleeding</kwd><kwd>arthropathy</kwd><kwd>concentrate of clotting factor VIII</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>гемофилия А</kwd><kwd>кровотечение</kwd><kwd>артропатия</kwd><kwd>концентрат фактора свертывания крови VIII</kwd><kwd>качество жизни</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Воробьев П.А., Краснова Л.С., Воробьев А.П., и др. 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