Combatt HMB-Recon: Combination Therapy in Adolescents to Treat Heavy Menstrual Bleeding-Review of Charts to Observe Treatment Patterns

• Published in: Blood 2024-11, Vol.144, p.556-556
• Main Authors: Amos, Lauren E., Yeh, Hung-Wen, Zia, Ayesha, Chitlur, Meera, Malec, Lynn, Wheeler, Allison P.
• Format: Article
• Language: English
• ISSN: 0006-4971
• DOI: 10.1182/blood-2024-210969

Heavy menstrual bleeding (HMB) negatively impacts women, disproportionately affecting adolescents. Severe HMB is associated with hospitalization, blood transfusions, and reduced quality of life yet no consensus for standard therapy exists. Combined contraceptive pills (COCPs) alone or in combination with tranexamic acid (TXA) are considered effective first-line treatment for HMB in bleeding disorders. However, safety concerns exist due to the theoretically increased thrombotic risk of combining estrogen and TXA leading to the United States FDA black box warning. No documented thromboembolic events in females with bleeding disorders using COCPs and TXA have occurred. Direct comparison between these treatment options is needed to improve outcomes and quality of life for this underrepresented population. We aimed to determine treatment patterns, effectiveness, and safety outcomes for adolescents with HMB and bleeding disorders. Our multi-center, retrospective, cohort study conducted at 5 Hemophilia Treatment Centers identified patients using an electronic medical record screening report with the inclusion criteria of female gender assigned at birth, ICD 9/10 codes for eligible bleeding disorder diagnoses, presence of at least one clinical encounter between 1/1/2015 to 4/1/2021, and age