safety and efficacy of secondary prophylactic in patients with severe hemophilia type a and b: a systematic review and meta-analysis study

Context: patients with hemophilia recieves coagulation factor replacement for lifetime. in iran, on-demand treatment method is used as standard. clinical studies have shown significant improvements in clinical and economic outcomes as a result of the use of prophylaxis compared with other therapies. the aim of this study was to evaluate safety and efficacy of prophylaxis in patients with severe hemophilia type a and b.evidence acquisition: this is a systematic review and meta-analysis in order to evaluate the safety and efficacy of prophylaxis treatment in patients with severe hemophilia. to this response, all clinical trials, cohorts, and case-control studies which have been investigated, published 1970 to sep 2017 and the results have been analyzed in stata.results: 1439 studies were found in primary search and 17 of them had inclusion criteria. the mean annual bleeding  rate in prophylays treatment was 2.8 times per person/year. this study also showed that in prophylaxis, the average incidence of adverse effects was 0.13 cases, and the severe adverse effects was 0.06 cases per person/year. conclusion: the analysis of the studies entered in this evaluation showed that the adverse effects were significantly lower in patients treated with prophylaxis than in patients treated with on-demand treatment. this difference was observed in severe adverse effect but it was not statistically significant and this shows that prophilaxis is safer than on-demand method. the lower annual bleeding rate in prophylaxis compared with the on-demand treatment method is also a sign of the effectiveness of prophilaxis.