The impact of ankle haemarthropathy in patients with moderate haemophilia

Introduction Moderate haemophilia has traditionally been associated with less complications than severe haemophilia. Changes in treatment recommendations have highlighted the burden of moderate haemophilia with a subset of patients with a severe bleeding phenotype. The ankle joint is disproportional...

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Bibliographic Details
Published in:Haemophilia : the official journal of the World Federation of Hemophilia 2023-03, Vol.29 (2), p.600-607
Main Authors: Wilkins, Richard A., Siddle, Heidi J., Chapman, Graham J., Horn, Elizabeth, Walwyn, Rebecca, Redmond, Anthony C.
Format: Article
Language:English
Subjects:
Ankle
Ankle Joint
ankles
Arthralgia
Bleeding
Feet
haemarthropathy
haemarthrosis
Hemophilia
Hemophilia A - complications
Hemorrhage - complications
Humans
moderate haemophilia
Pain
Pain - complications
Phenotypes
Quality of Life
Questionnaires
Citations: Items that this one cites
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Summary:Introduction Moderate haemophilia has traditionally been associated with less complications than severe haemophilia. Changes in treatment recommendations have highlighted the burden of moderate haemophilia with a subset of patients with a severe bleeding phenotype. The ankle joint is disproportionally affected by ankle haemarthropathy however the impact has not been evaluated in moderate haemophilia, nor the effect on health related quality of life (HRQoL) or foot and ankle outcomes. Aims To establish the impact of ankle haemarthropathy in patients with moderate haemophilia. Methods A multicentre questionnaire study recruited patients from 11 haemophilia centres in England, Scotland and Wales. The HAEMO‐QoL‐A and Manchester‐Oxford foot and ankle questionnaire (MOXFQ) with total and domain scores measured impact. Measures of pain and ankle haemophilia joint health (HJHS) scores were also collected. Results Twenty‐nine participants were recruited. HAEMO‐QoL A mean (SD) total scores of 10.8 (5.2) of 100 (best health) and foot and ankle specific MOXFQ total scores of 45.5 (24.7) above zero (best outcome) indicate poor HRQoL and foot and ankle outcomes. Average ankle pain over past 6 months of (0–10) 5.5 (SD2.5) was reported and median (IQR) ankle HJHS of 3.0 (1;12.5) to 4.5 (0;9.5) for the left and right ankles. Conclusion HRQoL and foot and ankle specific outcomes are poor in patients with moderate haemophilia and ankle haemarthropathy, driven by chronic levels of ankle joint pain. Despite moderate haemophilia being considered less affected by haemarthrosis and haemarthropathy, patients with a bleeding or haemarthropathy phenotype are clinically similar to patients with severe haemophilia A.
ISSN:1351-8216
1365-2516
DOI:10.1111/hae.14720