Hemophilia severity affects joint status, pain, health-related quality of life
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Elderly individuals with moderate or severe hemophilia had poorer joint or functional status and greater joint pain sensitivity than those with mild hemophilia or healthy controls, according to study results.
They also exhibited reduced health-related quality of life, findings showed.
Elderly individuals with hemophilia often experience pain, develop hemophilic arthropathy and experience reduced health-related quality of life. However, the extent of these conditions among older adults with mild hemophilia has not been extensively studied, according to study background.
Valérie-Anne Chantrain, PhD candidate in hematology and pain sciences at University of Antwerp in Belgium, and colleagues aimed to compare joint status, pain and health care-related quality of life among elderly individuals with mild hemophilia, those with moderate/severe hemophilia, and age-matched healthy controls.
Researchers used several methodologies to measure outcomes: They used:
• ultrasound (HEAD-US) and physical examination to assess knee and ankle abnormalities;
• the Brief Pain Inventory to evaluate pain severity and interference;
• a 2-minute walking test, the Timed Up-and-Go test and the Haemophilia Activities List to evaluate functional limitations; and
• the EQ-5D-5L questionnaire to assess health-related quality of life.
Investigators assessed pain thresholds at study participants’ knees/ankles and forehead.
The analysis included 40 individuals with hemophilia A or B — 17 with moderate/severe disease and 23 with mild — and 20 age-matched controls.
Results showed study participants with moderate/severe hemophilia had worse joint status, lower pressure pain thresholds and poorer health-related quality of life than those with mild hemophilia or healthy controls (P value range, .1 to < .001).
HEAD-US abnormalities occurred more frequently in the knees (100% vs. 50%) and ankles (94% vs. 61%) of individuals with moderate/severe hemophilia than mild hemophilia. A higher percentage of those with moderate/severe disease than mild disease reported pain (80% vs. 57%).
Some patients with mild hemophilia exhibited low pressure pain thresholds, functional limitations or poor health-related quality-of-life scores; however, outcomes did not differ significantly between those with mild hemophilia and healthy controls.
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