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Treatment and Joint Health in Nordic Moderate Haemophilia Patients – the Mohem Study

1Department of Haematology, Oslo University Hospital, Oslo, Norway, 2Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway, 3Institute of Clinical Medicine, University of Oslo, Oslo, Norway, 4Centre for Thrombosis and Haemostasis, Lund University, Malmö, Sweden, 5Centre for Thrombosis and Haemostasis, Skåne University Hospital, Lund University, Malmö, Sweden, 6Västra Götaland, Sahlgrenska University Hospital, Department of Medicine, Gothenburg, Sweden, 7Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden, 8Department of Haematology, Karolinska University Hospital, Stockholm, Sweden, 9Pediatric Coagulation, Karolinska University Hospital, Stockholm, Sweden, 10Coagulation Disorders Unit, Haematology, Comprehensive Cancer Centre, Helsinki University Hospital and Research Program in Systems Oncology, Faculty of Medicine, Helsinki University, Helsinki, Finland

Abstract Number: PB0331

Meeting: ISTH 2020 Congress

Theme: Coagulation and Natural Anticoagulants » FVIII/IX

Background: The prevalence of arthropathy in patients with moderate haemophilia is not well known.

Aims: We evaluated treatment and joint health in Nordic moderate haemophilia patients to explore if they receive optimal care.

Methods: The MoHem study is a cross-sectional, multicentre study covering patients with moderate haemophilia A (HA) and B (HB) in all ages from Sweden, Finland and Norway. Arthropathy was evaluated by ultrasound (HEAD-US) and Haemophilia Joint Health Score (HJHS). Data on treatment and medical history were self-reported supported by clinical records.

Results: We enrolled 145 patients with moderate haemophilia from Oslo, Stockholm, Malmö, Gothenburg and Helsinki. Median age was 28 years (IQR 13-52) and 89 (61%) had HA. Median baseline factor activity (lowest historical value) was 2.0 IU/dL (IQR 1.7-3.5): significantly lower for HB (2.0 IU/dL, IQR 1.4-2.0) than HA (2.8 IU/dL, IQR 2.0-4.0), p< 0.01. Fifty-five patients (38%) were receiving prophylactic treatment since median 10 years of age (IQR 4-24). 117 patients (81%) had a history of haemarthrosis: 76 (85%) among HA and 41 (73%) among HB, p=0.07. Median age at first joint bleed was 5 years (IQR 3-8) for the whole group: significantly lower for HA (5 years, IQR 3-7) than HB (7 years, IQR 5-12), p=0.01. Bleeding frequency was low: median number of joint bleeds and serious other bleeds during the last 12 months were both zero (IQR 0-1). Median total HEAD-US score for elbows, knees and ankles (n=120) was 0 points (IQR 0-2), while median total HJHS score (n=135) was 4 points (IQR 1-10), gait score excluded. Twenty-six patients (18%) had undergone joint surgery due to arthropathy. Correlation between HJHS and HEAD-US score was strong (r=0.74, p< 0.001).

Conclusions: Overall, the current joint health for Nordic moderate haemophilia patients was good. A subgroup of the patients had severe arthropathy. HEAD-US was strongly correlated with HJHS.

To cite this abstract in AMA style:

Måseide RJ, Berntorp E, Astermark J, Olsson A, Bruzelius M, Frisk T, Nummi V, Lassila R, Tjønnfjord GE, Holme PA. Treatment and Joint Health in Nordic Moderate Haemophilia Patients – the Mohem Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/treatment-and-joint-health-in-nordic-moderate-haemophilia-patients-the-mohem-study/. Accessed September 22, 2023.

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