People with hemophilia A and B reported similar impairment to health-related quality of life (HRQoL), with their scores largely impacted by joint damage these patients experience regardless of prophylaxis, according to an article recently published in Haemophilia.
The study enrolled 63 patients with severe hemophilia B and 63 matched controls with hemophilia A. All participants were asked to complete the EQ-5D-3L questionnaire consisting of 2 pages: the EQ-5D-3L descriptive system and the EQ visual analog scale. To assess the impact of joint health on quality of life, a physiotherapist or physician used the hemophilia joint health score 2.1 during the physical exam.
According to the results, 46% of participants with hemophilia B and 44% of participants with hemophilia A reported mobility problems, while pain and discomfort were noted by 62% and 56% of patients, respectively. Moreover, 33% of patients with hemophilia B and 17% of patients with hemophilia A reported anxiety and depression.
There was no significant difference between people with hemophilia A and B in terms of EQ-5D profiles, level sum score, EQ-5D index, or EQ visual analog scale score.
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On the other hand, linear regression adjusted for age showed that an increase in hemophilia joint health score was associated with a significant decrease in both the EQ-5D index and EQ visual analog scale score, suggesting that impaired joint health had a significant negative impact on HRQoL.
“In only two cases was mental illness recorded, and only six patients with hemophilia B reported use of antidepressants/anxiolytics, in contrast to the 21 individuals reporting problems in the EQ-5D dimension anxiety/depression,” Kihlberg and colleagues noted.
“Information on non-pharmaceutical treatments for anxiety/depression was unfortunately lacking, but despite this, the difference in numbers makes us consider that depression and anxiety might be unrecognized and undertreated in our hemophilia B patients.”
Chronic arthropathy is a common complication of hemophilia caused by frequent joint bleeding. Hemophilia B is associated with milder arthropathy than hemophilia A, however, HRQoL is affected by other factors that determine self-perception of well-being and functioning.
Kihlberg K, Baghaei F, Bruzelius M, et al. No difference in quality of life between persons with severe haemophilia A and B. Haemophilia. Published online February 15, 2023. doi:10.1111/hae.14759