Bleeding Into The Joints Leads To Joint Damage

Haemophilia. 2007 Nov ;13 Suppl 3 :4-9 17822514
Pathogenesis of haemophilic synovitis: clinical aspects.
[My paper] W K Hoots , N Rodriguez , L Boggio , L A Valentino
Arthropathy remains a major cause of morbidity in patients with
haemophilia. Frequent bleeding into the joints leads to joint damage
with resultant contractures, joint deformities and arthritis. This in
turn leads to muscle atrophy, limited physical activity, osteoporosis
and disability. Even though several studies of prophylactic factor
replacement for persons with severe haemophilia demonstrate improved
joint function, this therapy is still not readily available to most
people with haemophilia around the world and a universal treatment
protocol has not been used. In this article, we discuss key issues in
the treatment of severe haemophilia: the optimal timing of initiation
and termination of therapy, dosing options and goals of therapy. The
options for countries where prophylaxis is not readily available are
also discussed. Most studies are small and not randomized making
consensus treatment recommendations difficult to formulate.
Randomized, clinical trials are needed to provide the answers
regarding the optimal treatment of patients with severe haemophilia.

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