Joint status, pain and quality of life in elderly people with haemophilia: A case‐control study

Abstract

AbstractIntroductionElderly people with haemophilia (PwH) develop haemophilic arthropathy, pain, and reduced health‐related quality of life (HR‐QoL). The condition of elderly mild haemophilia patients have rarely been evaluated. This study aimed to compare joint status, pain, and HR‐QoL between elderly with mild, moderate/severe haemophilia and healthy elderlies.MethodsKnee/ankle abnormalities were assessed by ultrasound (HEAD‐US) and physical examination (HJHS 2.1). Pain severity and pain interference were investigated using the Brief Pain Inventory. Pressure pain thresholds (PPTs) were obtained at knees/ankles and forehead. Functional limitations were evaluated using the 2‐Minute‐Walking‐Test, Timed‐Up‐and‐Go and HAL. The EQ‐5D‐5L questionnaire evaluated HR‐QoL. Healthy controls (HCs) and elderly individuals with moderate/severe and mild haemophilia were compared using Kruskal–Wallis and Mann–Whitney U tests.ResultsFrom the 46 elderly PwH approached, 40 individuals (≥60 years) with haemophilia A/B (17 moderate/severe; 23 mild) and 20 age‐matched HCs were recruited. Moderate/severe PwH displayed worse joint status, lower PPTs, and poorer HR‐QoL than mild PwH and HCs (p‐value = .010–<.001). HEAD‐US abnormalities were observed in 100% of knees and 94% of ankles in moderate/severe PwH, versus 50% of knees and 61% of ankles in mild PwH. Pain was reported by 80% and 57% of moderate/severe and mild PwH, respectively. Low PPTs, functional limitations, and poor HR‐QoL scores were likewise observed in some mild PwH, yet without significantly differing from HCs.ConclusionThis study highlights poor joint/functional status, pain, and HR‐QoL outcomes in elderly with moderate/severe haemophilia. A few mild haemophilia subjects presented joint abnormalities, pain, functional limitations, and poor HR‐QoL, without significantly differing from HCs.Highlights Elderly individuals with mild haemophilia have not yet been extensively studied, whereas moderate/severe haemophilia individuals have proven to suffer from haemophilic arthropathy, pain, and poor health‐related quality of life (HR‐QoL). Using a case‐control design, joint status, pain, and HR‐QoL outcomes were examined in elderly haemophilia individuals and compared with those of healthy controls (HCs). Elderly moderate/severe haemophilia individuals exhibited worse joint status, increased joint pain sensitivity, and reduced HR‐QoL compared with both mild haemophilia subjects and HCs. A subset of mild haemophilia subjects exhibited poor joint status, pain, and HR‐QoL outcomes, without any differences noted when compared with HCs.