Prevalence, severity and correlation factors ofhemophilic arthropathy among Taiwanese hemophiliacs

Background:Hemophilic arthropathy(HA) is a major complication ofpatients with hemophilia(PWH), although its prevalence can bereduced with prophylaxis. The prophylaxis therapy for pediatric PWHwas implemented in Taiwan after 1995.Aims:We aim to analyze retrospectively the prevalence, severity, andcorrelation factors of HA among Taiwanese PWH.Methods:From 2006 to 2014, 146 severe/moderate-type PWH(134hemophilia A, 12 hemophilia B) were enrolled, with median age of 33(4–73). The data including disease severity, prophylaxis therapy, BMI,and HCV infection were collected. HA was assessed by X-ray films ofthe 6 index joints(elbows, knees, ankles) and scaled by Petterssonscore.Results:The age group-specific prevalence of HA was 42.8% in 4–10 year-old PWH, 64.3% in 11–19 year-old PWH, 97.1% in 20–29 year-old PWH, 93.1% in 30–39 year-old PWH, and 100% in PWHwith≥40y/o. The avergae joint number and Pettersson score of HAwas 1.3 and 1.9 in 4–10 year-old PWH, 1.4 and 4.1 in 11–19 year-oldPWH, 2.9 and 15.6 in 20–29 year-old PWH, 4.4 and 33.1 in 30–39 year-old PWH, 5.1 and 46.1 in 40–49 year-old PWH, 5 and 49.6 in PWH with≥50 years old. For PWH with age≤10 years old, a halfhad bilateral HA of ankle, and none of them had HA of knee. SevereHA were less found in<20 year-old PWH. In PWH with<40 y/o,prevalence of HA by location was ankles>elbows>knees. In PWHwith≥40 y/o, severe HA of elbow and knee accounted larger ratiothan that of ankle. By univariate analysis, age(≥18 y/o), severity,HCV infection, and prophylaxis therapy were significantly associatedwith total Pettersson score.(P<0.05) Both age and HCV infectionhad positive correlation with severity of HA.(r>0.7,P<0.01) Onlyage and severity were the independent factors by multivariate analysis.Conclusion:There was high prevalence of HA in Taiwanese PWH,especially in adult PWH. In pediatric PWH, HA of ankle was morecommon than other joints. With the implementationof prophylaxistherapy, the prevalence and severity of HA in PWH have been muchimproved.Disclosure of Interest:None Declared.