Researchers identified patients’ age and clotting factor levels as the main risk factors associated with the development of arthropathy in mild hemophilia, as published in Thrombosis Research.

“Patients with age >15.5 years and factor levels <17% appear to be the most susceptible,” the authors wrote. The median age of patients with arthropathy was 42 years, while patients without arthropathy had a median age of 15.5 years (P <.001).

The likelihood of developing arthropathy increased by 7.9% for each additional year, the authors said. The median baseline clotting factor levels were 10.5% and 17% in patients with and without arthropathy, respectively (P =.096). The likelihood of developing arthropathy decreased by 7.7% for each 1 IU/dL increase in baseline clotting factor.

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Moreover, they found an association between arthropathy and a greater history of joint bleeding. It is known that patients with mild hemophilia may experience episodes of joint and/or muscle bleeding. However, less frequent and less voluminous joint bleeds may go undiagnosed.

Therefore, the authors suggest further investigating arthropathy in patients with 4 reported hemarthroses. In contrast, arthropathy was not associated with the practice of physical activity, body mass index, type of hemophilia, hematological treatment, age at diagnosis, or any other variable analyzed.

“The practice of different levels of physical activity, including those of higher risk, did not appear to influence the onset of arthropathy,” the authors concluded. However, they advised that patients who develop arthropathy should be cautious regarding higher-risk activities, as they can potentiate the degree of joint damage.

Out of the 85 patients with mild hemophilia included in the study, 31 presented with some degree of arthropathy in at least 1 joint. The affected joints included the ankles, knees, and elbows.


De la Corte-Rodriguez H, Rodriguez-Merchan EC, Alvarez-Roman MT, Martin-Salces M, Rivas-Pollmar I, Jimenez-Yuste V. Arthropathy in people with mild haemophilia: exploring risk factors. Thromb Res. 2022;211:19-26. doi:10.1016/j.thromres.2022.01.010