WFH has various approaches towards clotting factor replacement therapy in hemophilia. Episodic treatment is the treatment given at the time of clinically evident bleeding. Primary prophylaxis is the regular continuous treatment initiated in the absence of documented bone changes in the joints, determined by physical examination and/or imaging studies, and started before the second clinically evident large joint bleed and age of three years. Secondary prophylaxis is the regular continuous treatment started after two or more bleeds into large joints (ankles, knees, hips, elbows and shoulders) and before the onset of joint disease documented by physical examination and imaging studies. Tertiary prophylaxis is the regular continuous treatment
