BACKGROUND: Treatment options for people with haemophilia are evolving at a rapid pace and a range of prophylactic treatment options using various technologies are currently available, each with their own distinct safety and efficacy profile. TREATMENT GOALS: The access to replacement therapy and prophylaxis has driven a dramatic reduction in mortality and resultant increase in life expectancy. Beyond this, the abolition of bleeds and preservation of joint health represent the expected, but rarely attained, goals of haemophilia treatment and care. These outcomes also do not address the complexity of health-related quality of life impacted by haemophilia and its treatment. CONCLUSION: Capitalizing on the major potential of therapeutic innovations, 'Normalization' of haemostasis, as a concept, should include the aspiration of enabling individuals to live as normal a life as possible, free from haemophilia-imposed limitations. To achieve this-being supported by the data reviewed in this manuscript-the concept of haemostatic and life Normalization needs to be explored and debated within the wider multidisciplinary teams and haemophilia community.

Coagulation Disorders Unit Department of Hematology Comprehensive Cancer Center Helsinki University Hospital Research Program Unit in Systems Oncology University of Helsinki Helsinki Finland

Department of Haematology Oslo University Hospital and Institute of Clinical Medicine University of Oslo Oslo Norway

Department of Hematology La Paz University Hospital IdiPaz Autonomous University Madrid Spain

Haemostasis and Thrombosis Unit Division of Haematology Cliniques universitaires Saint Luc Catholic University of Louvain Louvain Belgium

Hospital Bory Bratislava Slovakia

Institute of Experimental Hematology and Transfusion Medicine University Hospital Bonn Medical Faculty University of Bonn Bonn Germany

Katharine Dormandy Haemophilia and Thrombosis Centre Royal Free London London UK

Masaryk University Brno Czech Republic

National Coagulation Centre St James's Hospital Dublin Ireland and Trinity College Dublin Dublin Ireland

Regional Reference Centre for Inherited Bleeding Disorders University Hospital of Parma Parma Italy

UR4609 Hémostase and Thrombose University Lyon 1 Lyon France

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