A survey showed that pain interferes with health-related quality of life (HR-QoL) in men with hemophilia, regardless of disease severity. The study was recently published in Haemophilia.

“Pain is a major issue amongst [people with hemophilia], including people with mild hemophilia. Pain interferes with activities, emotions, sleep and HR-QoL, arguing for a comprehensive biopsychosocial approach of pain,” the study authors concluded.

According to the responders, pain interfered with general activity (99/176, 56%), walking (109/176, 62%), work (101/177, 57%), mood (93/175, 53%), relations with others (69/177, 39%), pleasure in life (84/177, 47%), and sleep (90/177, 51%).

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Statistical analyses of the results of the Brief Pain Inventory short-form (BPI) and the European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) revealed moderate correlations between the health utility index (EQ-HUI), pain severity (BPI-PS), and pain interference (BPI-PI) scores. BPI-PS explained 14% of the HR-QoL variance after adjusting for age and hemophilia severity.

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Most (118/177, 67%) responders reported pain in the last 24 hours, especially those with severe (79/92, 86%) or moderate (22/31, 71%) hemophilia. About half (62/126, 49%) of the responders with severe or moderate hemophilia reported 1 to 3 painful regions, 37% (47/126) reported more than 3 painful regions, and 13% (17/126) indicated no painful regions. Most (79/126, 63%) reported 1 painful ankle, 43% (54/126) had 1 painful knee, and 41% (52/126) reported at least 1 painful elbow.

In addition, 17 out of 54 (32%) responders with mild hemophilia reported pain in the last 24 hours. Thirty-three (18/55) responders identified 1 to 3 painful regions, whereas 60% (33/55) reported no painful regions. A minority of responders with mild hemophilia reported pain in synovial joints, including the knee (11/55, 20%), elbow (7/55, 13%), and ankle (5/55, 9%).

The survey was initiated by a Belgian organization for people with hemophilia, representing approximately 53% of the country’s population of people with hemophilia. 


Chantrain VA, Lambert C, De Smet P, et al. Pain interferes with daily activities, emotions and sleep in adults with severe, moderate and mild haemophilia: a national cross-sectional survey. Haemophilia. Published online January 19, 2023. doi:10.1111/hae.14747