Age‐specific incidence of joint disease in paediatric patients with haemophilia: A single‐centre real‐world outcome based on consecutive US examination

• Published in: Haemophilia : the official journal of the World Federation of Hemophilia Vol. 29; no. 5; pp. 1359 - 1365
• Main Authors: Mizoguchi, Yoko, Tani, Chihiro, Aizawa, Mika, Tomioka, Keita, Shimomura, Maiko, Nishimura, Shiho, Matsubara, Yoshiko, Iwaki, Daisuke, Tanaka, Kiyoto, Kawaguchi, Hiroshi, Nakashima, Yuko, Mikami, Yukio, Okada, Satoshi, Kobayashi, Masao
• Format: Journal Article
• Language: English
• Published: Chichester Wiley Subscription Services, Inc 01-09-2023
• Subjects: Age; Children; haemophilia; haemophilia treatment centre; Hemophilia; joint bleeding; joint disease; Joint diseases; paediatric; Pediatrics; Pharmacokinetics; Prophylaxis; Statistical analysis; Synovitis; ultrasound; United States > US
• ISSN: 1351-8216; 1365-2516
• DOI: 10.1111/hae.14848

Introduction
Joint health is one of the most important factors contributing to a healthy life in patients with haemophilia. Recent study revealed that starting early prophylaxis was not enough to prevent joint disease in most paediatric patients with haemophilia.
Aim
In this study, we aimed to determine the age‐specific incidence of acute joint disease during childhood at single haemophilia treatment centre (HTC).
Method
The joint health in 48 patients was evaluated based on consecutive US testing for 5 years at annual multidisciplinary comprehensive care.
Results
During the study period, 23 patients (47.9%) had no joint disease since the initial examination, whereas 13 patients (27.0%) showed development from negative to positive findings. The incidence of joint disease increased with age: 0% in preschool, 5.3% in elementary school, 14.3% in junior high school and 35% beyond high school age. Among the 13 patients who developed joint disease, two experienced acquired synovitis that resolved during the follow‐up period. Statistical analysis revealed that the patients who routinely underwent follow‐up by the HTC exhibited a significantly lower incidence of joint disease than did those followed up at other institutions (p < .001).
Conclusion
These results indicated that close check‐up, including routine joint examination using US as well as frequent assessment of pharmacokinetic profile at the HTC, might play an important role in avoiding joint disease among paediatric patients with haemophilia.