The effect of secondary prophylaxis versus episodic treatment on the range of motion of target joints in patients with haemophilia

Sweta Gupta, Azfar E.Alam Siddiqi, J. Michael Soucie, Marilyn Manco-Johnson, Roshni Kulkarni, Heidi Lane, Robina Ingram-Rich, Joan C. Gill

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

This study prospectively compared the effect of secondary prophylaxis to episodic treatment on target joint (TJ) range of motion (ROM), number of joint haemorrhages and new TJ development in patients with moderate or severe haemophilia. Two-hundred and eighty-six males, 17% in prophylaxis, 83% in episodic treatment group, participating in the Centers for Disease Control and Prevention's Universal Data Collection project, fulfilled inclusion criteria: age >2 years at enrolment, free of TJs at enrolment, developed at least one TJ after enrolment, and received either prophylaxis or episodic treatment continuously for two follow-up visits after TJ development. The outcomes of interest - percentage change in TJ ROM, number of joint haemorrhages and new TJ development, were modelled using multivariate linear, Poisson and logistic regression techniques respectively. Individuals who received secondary prophylaxis in comparison to episodic treatment were younger at TJ development (P < 0·01); there was no difference in the decrease in TJ ROM between the two groups (P = 0·9). Factors significantly associated with a higher rate of haemarthroses included episodic treatment, severe haemophilia, age >5 years at TJ development, obesity and inhibitor negative status. Secondary prophylaxis significantly decreased haemarthroses but was not associated with a significant improvement in TJ ROM or with new TJ development.

Original languageEnglish (US)
Pages (from-to)424-433
Number of pages10
JournalBritish Journal of Haematology
Volume161
Issue number3
DOIs
StatePublished - May 2013

Keywords

  • Episodic treatment
  • Haemophilia
  • Range of motion
  • Secondary prophylaxis
  • Target joint

ASJC Scopus subject areas

  • Hematology

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    Gupta, S., Siddiqi, A. E. A., Soucie, J. M., Manco-Johnson, M., Kulkarni, R., Lane, H., Ingram-Rich, R., & Gill, J. C. (2013). The effect of secondary prophylaxis versus episodic treatment on the range of motion of target joints in patients with haemophilia. British Journal of Haematology, 161(3), 424-433. https://doi.org/10.1111/bjh.12267