Association Between Aging and Health Status in Persons Leaving with Hemophilia and Controls Without a Bleeding Disorder - Insights from the PROBE Study

F. Germini^1,2, S. O'Callaghan³, C. Chai-Adisaksopha^2,4, R. Curtis⁵, N. Frick⁶, M. Nichol⁷, D. Noone^8,9, B. O'Mahony¹⁰, D. Page¹¹, J. Stonebraker¹², M. Skinner^1,13, A. Iorio^1,14, PROBE investigators

¹McMaster University, Health Research Methods, Evidence, and Impact, Hamilton, Canada, ²McMaster University, Medicine, Hamilton, Canada, ³Haemophilia Foundation Australia, Melbourne, Australia, ⁴Chiang Mai University, Department of Internal Medicine, Chiang Mai, Thailand, ⁵Factor VIII Computing, Berkeley, United States, ⁶National Hemophilia Foundation, New York, United States, ⁷University of Southern California, Sol Price School of Public Policy, Los Angeles, United States, ⁸Health Decisions Consultants, Dublin, Ireland, ⁹European Haemophilia Consortium, Brussels, Belgium, ¹⁰Trinity College Dublin, Dublin, Ireland, ¹¹Canadian Hemophilia Society, Montreal, Canada, ¹²Poole College of Management, North Carolina State University, Raleigh, United States, ¹³Institute for Policy Advancement Ltd, Washington, United States, ¹⁴McMaster University, McMaster-Bayer Endowed Research Chair in Clinical Epidemiology of Congenital Bleeding Disorders, Department of Medicine, Hamilton, Canada

Abstract Number: PB1012

Meeting: ISTH 2020 Congress

Theme: Hemophilia and Rare Bleeding Disorders » Hemophilia - Clinical

Background: People with hemophilia (PWH) have a life expectancy disadvantage as compared to the general population but little is known about the impact of aging on health status and health-related quality of life (HRQL).

Aims: Assessing the characteristics of the association between aging, health status and HRQL in PWH and people with no bleeding disorders (PWNoBD).

Methods: A cross-sectional, multinational study was conducted as part of the Patient Reported Outcomes, Burdens and Experiences (PROBE) project. PWH and PWNoBD were asked to complete the PROBE questionnaire. Measures of health status and HRQL were the PROBE score, the EQ-5D-5L utility index, and the EuroQol visual analog scale (EQ-VAS) of global health. The association between these measures and the age of participants was explored using a multivariable model adjusting for sex (all) and disease severity (PWH only) and stratifying by country.

Results: 1157 PWH and 690 PWNoBD completed the questionnaire in 33 countries from 2016 to 2019. Study population demographics are reported in Table 1. Eight percent of the PWH and 12% of the PWNoBD were aged ≥65 years. Multivariable analysis results are reported in Table 2. As expected, the EQ-5D utility index and EQ-VAS did not show a variation with aging in PWNoBD, while in PWH they were reduced respectively by 0.031 (95% confidence interval [CI] 0.021-0.041) and 0.030 (95% CI 0.014-0.047) every 10 years. Aging was associated with a mean reduction in the PROBE score of 0.010 (95% CI 0.004 to 0.017) every 10 years in PWNoBD. PWH showed an additional reduction in the PROBE score of 0.015 (95% CI 0.008 to 0.022) every 10 years.

Conclusions: Aging is associated with a steeper decrease in health status and HRQL in PWH than in PWNoBD. PROBE is more sensitive than EQ5D in measuring the association of aging for the specific domains measured in both PWH and PWNoBD.

[Table 1: demographics of the study population]

*Unless otherwise specified **Row percentage (across age categories), all other percentages are within risk categories. ***This refers to the average per-capita income of the country according to the World Bank.
Q1: first quartile; Q2: third quartile; PROBE = patient reported outcomes burden and experience; VAS = visual analogue scale

[Table 2: results of the multivariate analysis using a generalized linear model]

To cite this abstract in AMA style:

Germini F, O'Callaghan S, Chai-Adisaksopha C, Curtis R, Frick N, Nichol M, Noone D, O'Mahony B, Page D, Stonebraker J, Skinner M, Iorio A, PROBE investigators . Association Between Aging and Health Status in Persons Leaving with Hemophilia and Controls Without a Bleeding Disorder – Insights from the PROBE Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/association-between-aging-and-health-status-in-persons-leaving-with-hemophilia-and-controls-without-a-bleeding-disorder-insights-from-the-probe-study/. Accessed October 20, 2020.

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