Arterial and Venous Thrombosis in Haemophilia Patients: Experiences from a Danish Haemophilia Centre

Larsen, Julie Brogaard; Nielsen, Karen Bang Jin; Poulsen, Lone Hvitfeldt; Bor, Mustafa Vakur

doi:10.1159/000477928

Cited by 8 publications

(22 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a prospective series of 29 major orthopaedic procedures in PWH without any pharmacological thromboprophylaxis in which they used Doppler ultrasound on day 8 to screen for VTE, only 3 distal asymptomatic DVT were found 36 . Most of these thrombi are also reported to resolve spontaneously without any antithrombotic therapy with removal of the risk factors 36,37 …”

Section: Thrombosis In Patients With Haemophiliamentioning

confidence: 99%

Management of comorbidities in haemophilia

2020

View full text Add to dashboard Cite

With the introduction of clotting factor concentrates in the early 1970s, significant improvements in quality of life and life expectancy of persons with haemophilia (PWH) were realized. Unfortunately, as a result of transmission of HIV and hepatitis C virus (HCV) by contaminated concentrates in the 1980s, many of these gains were lost. Now with four decades of PWH unexposed to contaminated factor products and current treatments capable of suppressing and eliminating HIV and HCV, respectively, the survival rate is once again increasing. In addition to the usual comorbidities associated with advanced age in the general population, several specific issues occur in patients with bleeding disorders. This manuscript explores the incidence and management of the comorbidities of the ageing PWH with a focus on cardiovascular disease and osteoporosis.

show abstract

Section: Thrombosis In Patients With Haemophiliamentioning

confidence: 99%

Management of comorbidities in haemophilia

2020

View full text Add to dashboard Cite

show abstract

“…As a known but rare complication of HA treatment, some approved products have boxed warnings on their product labels regarding thrombosis 8,9,27 . Thrombosis‐related mortality is receiving increasing attention as PwcHA live longer and develop other comorbidities (eg, hypertension, atherosclerosis), 28 and as newer therapies have altered the kinetics of hemostatic protection from the frequent peaks and troughs of factor replacement toward more steady‐state coagulation potential through novel mechanisms of action (eg, FVIII replacement with bispecific antibody, messenger RNA antisense/rebalancing, gene therapy) or pharmaceutical modifications of replacement clotting factors (eg, extended half‐life products). It is crucial to determine whether there are any changes in the incidence of thrombosis caused by the novel mechanisms of action of newer treatments.…”

Section: Resultsmentioning

confidence: 99%

Establishment of a framework for assessing mortality in persons with congenital hemophilia A and its application to an adverse event reporting database

Pipe

Kruse‐Jarres

Mahlangu

et al. 2021

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

Background Despite recent therapeutic advances, life expectancy in persons with congenital hemophilia A (PwcHA) remains below that of the non‐HA population. As new therapies are introduced, a uniform approach to the assessment of mortality is required for comprehensive evaluation of risk–benefit profiles, timely identification of emerging safety signals, and comparisons between treatments. Objectives Develop and test a framework for consistent reporting and analysis of mortality across past, current, and future therapies. Patients/Methods We identified known causes of mortality in PwcHA through literature review, analysis of the US Food and Drug Administration Adverse Event Reporting System (FAERS) database, and expert insights. Leading causes of death in general populations are those recognized by the Centers for Disease Control and Prevention and the World Health Organization. We developed an algorithm for assessing fatalities in PwcHA and used this to categorize FAERS data as a proof of concept. Results PwcHA share mortality causes with the non‐HA population including cardiovascular disease, malignancy, infections, pulmonary disease, dementias, and trauma/suicide. Causes associated with HA include hemorrhage, thrombosis, human immunodeficiency virus, hepatitis C virus, and liver dysfunction. We propose an algorithm employing these classes to categorize fatalities and use it to classify FAERS fatality data between 01/01/2000 and 03/31/2020; the most common causes were hemorrhage (22.2%) and thrombosis (10.4%). Conclusions A conceptual framework for examining mortality in PwcHA receiving any hemophilia therapy is proposed to analyze and interpret fatalities, enabling consistent and objective assessment. Application of the framework using FAERS data suggests a generally consistent pattern of reported mortality across HA treatments, supporting the utility of this unified approach.

show abstract

“…Hypertension and obesity tend to become endemic in the hemophilic population [9,39,131]. The prevalence of the cardiovascular disease varies between studies, ranging from <2% to 20% depending on the age of the hemophiliacs enrolled and the severity of their disease [72]. Ischemic heart disease is found in an increasing number of hemophilic patients, especially if they are old and with cardiovascular risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…In the Danish cohort of hemophiliacs, four of five patients with AMI treated before 2013 were managed conservatively. In two cases, CABG was performed after 2 and 9 months after the acute event, respectively [72]. Peng et al reported the successful management of a difficult case of NSTEMI complicated with respiratory and cardiac arrest in a patient with severe hemophilia A [73].…”

Section: Selection Of the Reperfusion Therapymentioning

confidence: 99%

See 1 more Smart Citation

Current Therapeutic Approach to Acute Myocardial Infarction in Patients with Congenital Hemophilia

Bădescu

Ciocoiu

Rezuş

et al. 2021

Life

View full text Add to dashboard Cite

Advances in the treatment of hemophilia have made the life expectancy of hemophiliacs similar to that of the general population. Physicians have begun to face age-related diseases not previously encountered in individuals with hemophilia. Treatment of acute myocardial infarction (AMI) is particularly challenging because the therapeutic strategies influence both the patient’s thrombotic and hemorrhagic risk. As progress has been made in the treatment of AMI over the last decade, we performed an in-depth analysis of the available literature, highlighting the latest advances in the therapy of AMI in hemophiliacs. It is generally accepted that after the optimal substitution therapy has been provided, patients with hemophilia should be treated in the same way as those in the general population. New-generation stents that allow short dual antiplatelet therapy and potent P2Y12 receptor inhibitors have begun to be successfully used. At a time when specific recommendations and relevant data are scarce, our study provides up-to-date information to physicians involved in the treatment of AMI in hemophiliacs.

show abstract

Arterial and Venous Thrombosis in Haemophilia Patients: Experiences from a Danish Haemophilia Centre

Cited by 8 publications

References 18 publications

Management of comorbidities in haemophilia

Management of comorbidities in haemophilia

Establishment of a framework for assessing mortality in persons with congenital hemophilia A and its application to an adverse event reporting database

Current Therapeutic Approach to Acute Myocardial Infarction in Patients with Congenital Hemophilia

Contact Info

Product

Resources

About