Joint condition of patients with haemophilia in Hong Kong

Rachel Lai-Chu Kwan, Grace Kee-See Lam, Lydia Kai-Pik Kwok, Siu-Yung Wong, Henry Hon-Wai Lam, Kit Wai, Raymond Siu-Ming Wong
Purpose:

This study aims to (1) establish the database on Haemophilia Joint Health Score (HJHS) and Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) protocol for patients with haemophilia in Hong Kong, (2) evaluate correlation of HJHS and HEAD-US with different haemophiliac conditions.

Methods:

Patients with severe and moderate haemophilia A or B in Hong Kong were recruited to participate the study and assessed by clinical assessment and ultrasonography on bilateral elbow, knee and ankle joints. A questionnaire, including the demographic information, disease type and severity, the replacement frequency and dosage of factor concentrates, was filled prior to the assessment.

Results:

Seventy-one patients (mean age 34.3 years; mean BMI 23.2 kg/m2, 81.7% Haemophilia A and 18.3% Haemophilia B; 54.9% severe and 45.1% moderate) participated in the study with 426 joints assessed. Thirty-five percent of patient did not know the name of antihemophilic agents used; while 8.5% used Factor VIII mimetic bispecific antibody; 18.3% extended half-life recombinant factor VIII; 7% extended half-life recombinant factor IX; 31% plasma derived factor VIII. Fifty-five percent of patient were in prophylaxis; 12.7% were on demand and 32.4% were in both. 

For the 426 joints assessed in 71 patients, 225 (52.8%) joints showed positive (≥1 point) in HEAD-US: 71 elbow joints, 70 knee joints and 84 ankle joints. In HJHS, 343 joints showed positive (≥1 points): 86 elbow joints, 125 knee joints and 132 ankle joints. HEAD-US correlated strongly with HJHS (r=0.828, p0.001). HEAD-US and HJHS correlated with age respectively (r=0.592, p0.001 and r=0.517, p0.001). There were no correlations between HEAD-US and HJHS with BMIbody weight.

Conclusion(s):

In 426 joints assessed, 52.8% and 80.5% joints showed positive in HEAD-US and HJHS respectively, the highest prevalence in ankle joints. HEAD-US correlated strongly with HJHS. HEAD-US and HJHS correlated with age separately.

Implications:

DatabUltrasonography may be a useful tool to detect early joint damage of patients with haemophilia. It gives more information to clinicians for personalized injection regime and treatment plan for the patient.

Funding acknowledgements:
Sanofi Hong Kong Limited
Keywords:
Haemophilia
Ultrasonography
Joint conditions
Primary topic:
Orthopaedics
Second topic:
Musculoskeletal
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Tung Wah College Research Ethics Committee
Provide the ethics approval number:
MHS_SRC_2021_009
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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