Joint health and treatment modalities in Nordic patients with moderate haemophilia A and B – The MoHem study

Måseide, Ragnhild Johanne; Berntorp, Erik; Astermark, Jan; Olsson, Anna; Bruzelius, Maria; Frisk, Tony; Nummi, Vuokko; Lassila, Riitta; Tjønnfjord, Geir E.; Holme, Pål André

doi:10.1111/hae.14114

Cited by 26 publications

(79 citation statements)

References 22 publications

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“…Patient characteristics and major outcomes of the MoHem study (Table 1) have been reported previously 20 . We assessed 693 joints in 118 patients by HEAD‐US and HJHS.…”

Section: Resultsmentioning

confidence: 99%

“…The MoHem study is a cross‐sectional, multicentre study that covers MHA and MHB (FVIII/FIX:C 1–5 IU/dl) 21 of all ages from Sweden, Finland and Norway. The recruitment to the study has been described previously 20 . Briefly, the enrolment took place at the Haemophilia Comprehensive Care Centres (HCCC) in Oslo, Malmö, Gothenburg, Stockholm and Helsinki between January 2017 and October 2019.…”

Section: Methodsmentioning

confidence: 99%

“…Detection of early‐stage arthropathy may therefore be decisive for initiation of regular prophylaxis in patients with moderate haemophilia. In the MoHem study, we evaluated the current joint health in Nordic patients with moderate haemophilia A (MHA) and B (MHB) using HEAD‐US and HJHS 20 . Overall, the joint health was close to normal with total HEAD‐US 0/48 points (median; IQR 0–2) and HJHS 4/120 points (IQR 1–10).…”

Section: Introductionmentioning

confidence: 99%

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Haemophilia early arthropathy detection with ultrasound and haemophilia joint health score in the moderate haemophilia (MoHem) study

et al. 2021

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Introduction Detection of early arthropathy is crucial for the management of haemophilia, but data on moderate haemophilia are limited. Therefore, we evaluated joint health and treatment modalities in Nordic patients with moderate haemophilia A (MHA) and B (MHB). Aim To explore and compare the Haemophilia Early Arthropathy Detection with Ultrasound (HEAD‐US) and Haemophilia Joint Health Score (HJHS) to detect early arthropathy in moderate haemophilia. Methods A cross‐sectional, multicentre study covering Nordic patients with MHA and MHB. Arthropathy was evaluated by HEAD‐US and HJHS 2.1. Results We assessed 693 joints in 118 patients. HEAD‐US scores (medians [interquartile ranges]) were as follows: elbows 0 points (0–0), knees 0 (0–0) and ankles 0 (0–1). Respectively, by HJHS: elbows 0 (0–1), knees 0 (0–1) and ankles 0 (0–1). Cartilage (14%) and bone (13%) were most commonly affected by HEAD‐US. Frequent HJHS findings were crepitus on motion in knees (39%), and loss of flexion (23%) and extension (13%) in ankles. HEAD‐US correlated strongly with HJHS (elbows r = .70, knees r = .60 and ankles r = .65), but 24% had discordant scores. Joints with HJHS zero points, 5% captured HEAD‐US ≥1 point. Moreover, 26% had HJHS findings without HEAD‐US pathology. Notably, 31% of knees had crepitus on motion and normal HEAD‐US. Conclusion Overall, the joints attained low scores implying good joint health. HEAD‐US correlated strongly with HJHS. In 5%, HEAD‐US detected subclinical pathology. Crepitus on motion was frequently reported despite normal HEAD‐US, thus not necessarily reflecting arthropathy. HEAD‐US therefore improves the joint assessment in moderate haemophilia.

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“…Patient characteristics and major outcomes of the MoHem study (Table 1) have been reported previously 20 . We assessed 693 joints in 118 patients by HEAD‐US and HJHS.…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Haemophilia early arthropathy detection with ultrasound and haemophilia joint health score in the moderate haemophilia (MoHem) study

et al. 2021

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“…The main clinical results from the MoHem study have been reported previously 13 . Thromboelastometry was performed on 52 patients from Oslo, and TG was performed on 66 patients from Oslo and Helsinki.…”

Section: Resultsmentioning

confidence: 99%

“…The MoHem study is a cross‐sectional, multicentre study covering Nordic patients with MHA and MHB. The study recruitment has been described previously 13 . Evaluation by global coagulation assays was optional, and only patients from Oslo and Helsinki above 5 years of age took part.…”

Section: Methodsmentioning

confidence: 99%

Bleeding phenotype of patients with moderate haemophilia A and B assessed by thromboelastometry and thrombin generation

et al. 2021

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Introduction Predicting the bleeding phenotype is crucial for the management of patients with moderate haemophilia. Global coagulation assays evaluate haemostasis more comprehensively than conventional methods. Aim To explore global coagulation assays and the bleeding phenotype of patients with moderate haemophilia A (MHA) and B (MHB). Methods The MoHem study is a cross‐sectional, multicentre study covering Nordic patients with MHA and MHB. Thromboelastometry in whole blood and thrombin generation (TG) in platelet‐poor plasma (1, 2.5 and 5 pM tissue factor (TF)) were compared with joint health (Haemophilia Joint Health Score (HJHS)) and treatment modality. Results We report on 61 patients from Oslo and Helsinki: 24 MHA and 37 MHB. By TG (2.5 pM TF), patients who had been without replacement therapy during the previous 12 months depicted higher endogenous thrombin potential (P = .03). In contrast, those who had low ETP (< median) captured higher HJHS (P = .02). Patients who had undergone orthopaedic surgery generated least thrombin (P = .02). By thromboelastometry, those without the need of factor consumption had short clotting times, and quick times to maximum velocity (< median values) (P = .03). Factor VIII/factor IX activity (FVIII/FIX:C) did not align with the bleeding phenotype, but FIX:C ≤ 3 IU/dL was associated with lower peak thrombin (P = .03). Conclusion TG differentiated patients with moderate haemophilia according to HJHS, annual factor consumption, and whether orthopaedic surgery had been performed. Thromboelastometry differentiated according to factor consumption only. Global coagulation assays may assist predicting the bleeding phenotype in moderate haemophilia.

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Bleeding phenotype according to factor level in 825 children with nonsevere hemophilia: data from the PedNet cohort

de Kovel,

Escuriola-Ettingshausen,

Königs

et al. 2024

Journal of Thrombosis and Haemostasis

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Joint health and treatment modalities in Nordic patients with moderate haemophilia A and B – The MoHem study

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 26 publications

References 22 publications

Haemophilia early arthropathy detection with ultrasound and haemophilia joint health score in the moderate haemophilia (MoHem) study

Haemophilia early arthropathy detection with ultrasound and haemophilia joint health score in the moderate haemophilia (MoHem) study

Bleeding phenotype of patients with moderate haemophilia A and B assessed by thromboelastometry and thrombin generation

Bleeding phenotype according to factor level in 825 children with nonsevere hemophilia: data from the PedNet cohort

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