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. 2022 Jun;108(6):518-527.
doi: 10.1111/ejh.13763. Epub 2022 Mar 30.

Pain and functional disability amongst adults with moderate and severe haemophilia from the Irish personalised approach to the treatment of haemophilia (iPATH) study

Megan Kennedy  1 , Brian O' Mahony  2 , Sheila Roche  3 , Mark McGowan  3 , Evelyn Singleton  3 , Kevin Ryan  3 , Niamh M O' Connell  3 , Steven W Pipe  4 , Michelle Lavin  3   5 , James S O' Donnell  3   5 , Peter L Turecek  6 , John Gormley  1 ; on behalf of the iPATH study group
Affiliations

Pain and functional disability amongst adults with moderate and severe haemophilia from the Irish personalised approach to the treatment of haemophilia (iPATH) study

Megan Kennedy et al. Eur J Haematol. 2022 Jun.

Abstract

Objectives: To establish the prevalence of pain and functional disability in Irish adults with moderate and severe haemophilia, and to examine demographic and lifestyle influences.

Methods: Males ≥18 years with moderate or severe haemophilia participated. Pain and function were examined using the PROBE questionnaire.

Results: Of 49 participants [median age 44 (IQR 32, 52) years], most had severe haemophilia (Factor VIII = 30; Factor IX = 13) and were on regular prophylaxis (88%). Those with moderate haemophilia (Factor VIII = 5; Factor IX = 1) treated on demand (12%). Acute (72%) and chronic pain (71%), functional difficulties (58%), and analgesic requirements (92%) were prevalent. Age was significantly associated with more advanced haemophilic arthropathy (p = .002), chronic pain (p = .029) and functional difficulties (p = .036). Adults who reported chronic pain commenced prophylaxis significantly later in life [32 (20, 51) vs. 8 (1, 23) years; p = .004]. Physical activity was significantly lower in those with functional difficulties (p < .05). A disparity between self-perceived 'target joints' and clinically defined target joints was also identified (76% vs. 23%).

Conclusion: Haemophilic arthropathy, pain and functional disability were prevalent amongst Irish adults with moderate and severe haemophilia. Age-dependent lifestyle, analgesic and treatment influences on pain and function warrant further investigation.

Keywords: function; haemophilia; pain; physical activity; prophylaxis.

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Conflict of interest statement

M.L. has served on an advisory board to Tremeau Pharmaceuticals and as a consultant to Sobi. She received indirect funding from Takeda for the development of educational material. N.M. O’C. has received research support from SOBI; participated in advisory boards for F. Hoffmann‐La Roche Ltd, UniQure, SOBI, Freeline; and participated in speakers’ bureaus for F. Hoffmann‐La Roche Ltd, SOBI and Novo Nordisk. J.S. O’D. has served on the speaker's bureau for Baxter, Bayer, Novo Nordisk, Boehringer Ingelheim, Leo Pharma, Takeda and Octapharma. He has also served on the advisory boards of Baxter, Bayer, Octapharma CSL Behring, Daiichi Sankyo, Boehringer Ingelheim, Takeda and Pfizer. J.S. O’D. has received research grant funding awards from Baxter, Bayer, Pfizer, Shire (now part of Takeda), Takeda and Novo Nordisk. P.L.T. is full‐time employee of Baxalta Innovations GmbH, a member of the Takeda group of companies, and shareholder of Takeda Pharmaceutical Company Limited. M.K. has served on an advisory council to Takeda. The remaining authors have no competing interests to declare.

Figures

FIGURE 1
FIGURE 1
Recruitment flow chart
FIGURE 2
FIGURE 2
Use of pharmacological analgesia by age group
See this image and copyright information in PMC

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