Abstract Number: PB0943
Meeting: ISTH 2020 Congress
Theme: Hemophilia and Rare Bleeding Disorders » Hemophilia - Clinical
Background: HA is a congenital bleeding disorder caused by a deficiency in clotting factor (F) VIII. Bleeding frequency and progressive joint damage correlates with increasing disease severity, however the relationship between bleeding tendency and level of engagement in activities is not currently well understood.
Aims: To examine physical activity and bleeding frequency in adults with HA without current FVIII inhibitors.
Methods: This analysis draws on 12 months’ retrospective data from adults with mild, moderate, and severe HA (defined according to endogenous FVIII [IU/dL]) enrolled in the CHESS II (Cost of Haemophilia in Europe: a Socioeconomic Survey-II) burden-of-illness study, across 8 European countries. Data on bleed frequency reported by hemophilia specialists was analyzed along with physical activity levels reported on patient-completed forms. Patient-reported activity level was classified as ‘none’ or ‘any’, based on participation in any recreation and fitness-based activity such as jogging, cycling, or team sport, among others, but excluding activities such as walking and gardening. Limitations include the variability of the endpoint and cross-sectional design. Informed consent was obtained and the study was approved by University of Chester ethical committee.
Results: Of 787 patients profiled in the interim CHESS dataset, approximately 41% (n=258) of the 628 patients with HA returned patient-completed forms. Of this cohort 16% (n=41), 28% (n=72), and 56% (n=145) had mild, moderate, and severe HA, respectively (Table 1). Mean (SD) age was 38.66 (14.86), 39.96 (15.66) and 37.42 (14.57) years, and mean (SD) BMI was 24.55 (2.25), 24.94 (2.94) and 24.66 (2.57), in the mild, moderate, and severe cohorts, respectively. Higher levels of physical activity were predominantly associated with more frequent bleeding episodes in the moderate and severe HA groups (Table 2).
Conclusions: In people with moderate and severe HA, the data suggest a trend towards increased participation in sports and recreational activities and bleeding frequency.
| Mild HA (n=41) | Moderate HA (n=72) | Severe HA (n=145) | ||||
| No Activity | Any Activity | No Activity | Any Activity | No activity | Any activity | |
| Treatment strategy,n No treatment On-demand Prophylaxis All, n (%) |
9 |
16 |
20 |
25 |
0 |
0 |
| Problem joint, n (%) | 4 (24) | 4 (17) | 14 (40) | 14 (38) | 36 (45) | 32 (49) |
| Target joint, n (%) | 1 (6) | 1 (4) | 6 (17) | 5 (14) | 32 (40) | 35 (54) |
| HA, hemophilia A. | ||||||
[Table 1. Baseline Characteristics of People with Mild, Moderate, and Severe HA, by Activity Level]
| Mild HA (n=41) | Moderate HA (n=72) | Severe HA (n=145) | All HA (n=258) | |||
| Treatment strategy, n | Any | Any | Any | Prophylaxis (n=87) | Any | Prophylaxis (n=94) |
| Activity level | ||||||
| None* n ABR, mean (SD) |
17 1.41 (0.87) |
35 2.31 (2.00) |
80 3.53 (2.78) |
51 3.73 (2.82) |
132 2.93 (2.53) |
55 3.62 (2.75) |
| Any* n ABR, mean (SD) |
24 1.29 (0.95) |
37 2.92 (4.62) |
65 4.46 (3.07) |
6 5.14 (3.33) |
126 3.40 (3.56) |
39 4.90 (3.31) |
| *Activity level was classified as either ‘none’ or ‘any’ activity. ABR, annual bleed rate; HA, hemophilia A; SD, standard deviation. |
||||||
[Table 2. Activity Levels and Bleeding Frequency in People with Mild, Moderate, and Severe HA]
To cite this abstract in AMA style:
Nissen F, Burke T, Asghar S, Shang A, Aizenas M, Meier O, O'Hara J. Associations between Physical Activity Levels and Bleeding Frequency in People with Mild, Moderate, and Severe Hemophilia A (HA): A Preliminary Analysis of the CHESS II Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/associations-between-physical-activity-levels-and-bleeding-frequency-in-people-with-mild-moderate-and-severe-hemophilia-a-ha-a-preliminary-analysis-of-the-chess-ii-study/. Accessed October 1, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/associations-between-physical-activity-levels-and-bleeding-frequency-in-people-with-mild-moderate-and-severe-hemophilia-a-ha-a-preliminary-analysis-of-the-chess-ii-study/