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Observational Study
. 2025 Mar;31(2):239-246.
doi: 10.1111/hae.70012. Epub 2025 Feb 24.

Impact of Systematic Joint Examination (Ultrasound, Functional and Physical) on Treatment Management Decisions in Patients With Haemophilia A in France: Final Data From the Prospective, Observational A-MOVE Study

Nicolas Drillaud  1 , Virginie Barbay  2 , Jean Baptiste Valentin  3 , Romain Jailler  4 , Aurélien Lebreton  5 , Brigitte Pan-Petesch  6 , Sabine Marie Castet  7 , Birgit Frotscher  8 , Laurent Frenzel  9 , Sandrine Jousse-Joulin  10 , Hervé Chambost  11 , Mikaela Alenäs  12 , Markus Fusser  12 , Corinne Gandossi  13 , Meriem Zidi  13 , Oussama Mahdout  13 , Yohann Repessé  14 ; A‐MOVE study group
Collaborators, Affiliations
Observational Study

Impact of Systematic Joint Examination (Ultrasound, Functional and Physical) on Treatment Management Decisions in Patients With Haemophilia A in France: Final Data From the Prospective, Observational A-MOVE Study

Nicolas Drillaud et al. Haemophilia. 2025 Mar.

Abstract

Background: Haemophilia management aims to prevent bleeding and preserve joint function. Changes in patients' joint health may influence physicians' decisions to adjust treatment. The Haemophilia Joint Health Score (HJHS) and Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) score assess joint health but are not routinely used.

Aim: To evaluate whether systematic joint examination with HJHS and/or HEAD-US had an impact on treatment management decisions in France, using final data from the A-MOVE study.

Methods: A-MOVE (NCT04133883) was a 12-month prospective, multicentre study, which enrolled persons with haemophilia A (all severities, aged 6-40 years) treated prophylactically or on demand with standard/extended half-life FVIII replacement. At baseline, 6 and 12 months, HJHS/HEAD-US and changes in patients' management were assessed.

Results: Eighty-six patients from 20 sites were included in the final analysis; 68 had HJHS/HEAD-US assessments at 12 months. Over 12 months, 24.4% (n = 21/86) of patients experienced an impact on their haemophilia management due to HJHS/HEAD-US scores; these decisions were impacted by HJHS in about half of the patients (52.4%, n = 11/21) and HEAD-US in almost all patients (95.2%, n = 20/21). Both assessments contributed to a change in management decisions in about half of the patients (47.6%, n = 10/21). Twenty-nine patients (33.7%) had haemophilia management decisions impacted by factors other than HJHS/HEAD-US, including physical examination findings (n = 9) and the occurrence of bleeding episodes (n = 8).

Conclusions: Final data from the A-MOVE study show that systematic joint assessments, through functional/physical examination (HJHS) and ultrasound (HEAD-US), may impact treatment management decisions in persons with haemophilia A.

Keywords: arthropathy; factor VIII; haemophilia; joints; prophylaxis; ultrasound.

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Conflict of interest statement

Nicolas Drillaud: Research grants from Novo Nordisk; speaker/honoraria for Octapharma, Roche Chugaï and Sobi. Virginie Barbay: Speaker/honoraria for LFB; consulting fees from Sobi; grant/research support from CSL Behring. Jean Baptiste Valentin: Consultant for Sobi, has received hospitality from Octapharma, Roche and CSL Behring. Romain Jailler: Research grants from Sobi. Aurélien Lebreton: Grant/research support from CSL Behring, Novo Nordisk, Octapharma and Sobi; consultant for Bayer, LFB, Octapharma, Pfizer, Roche and Sobi. Brigitte Pan‐Petesch: Consultant for BioMarin, CSL Berhing, Novo Nordisk, Roche/Chugai, Sobi and Takeda. Sabine Marie Castet: Consultant (advisory board honoraria or invitation as speaker in symposia) for CSL Behring, LFB, Novo Nordisk, Roche, Sobi and Takeda. Birgit Frotscher: Consultant for BioMarin, CSL Behring, Novo Nordisk, Sobi and Takeda. Laurent Frenzel: Consulting fees are from CSL Behring, Pfizer, Roche and Sobi. Sandrine Jousse‐Joulin: No conflicts of interest to declare. Hervé Chambost: Consulting fees from BioMarin, CSL Behring, Pfizer, Roche Chugai and Sobi; payment/honoraria for lectures/speakers bureau from BioMarin, CSL, Roche Chugai and Sobi; payment for expert testimony from BioMarin; support for attending meetings from BioMarin, Novo Nordisk, Roche and Sobi. Mikaela Alenäs: Contractor for Sobi; consultant for Aixial Group. Markus Fusser, Corinne Gandossi, Meriem Zidi, Oussama Mahdout: Employees and/or shareholders of Sobi. Yohann Repessé: Grant/research support from CSL Behring and Octapharma; consultant for (scientific advisory board honoraria) LFB, Roche and Sobi.

Figures

FIGURE 1
FIGURE 1
Haemophilia management changes other than FVIII treatment. Some patients experienced multiple treatment changes. aOther changes include chiropodist orthopaedic insoles, radiography, rheumatology consultation, ankle x‐ray prescription, co‐occurring treatment, MRI prescription, proposed corticoids and a discussion to change from prophylactic to non‐replacement therapy. bOther changes include rheumatologist consultation, decreased sports activity, increased prophylaxis, prescribed physiotherapy, stimulation physical activity, MRI, radiography and treatment change to non‐factor replacement therapy. FVIII, factor VIII; HCP, healthcare professional; HEAD‐US, Haemophilia Early Arthropathy Detection with Ultrasound, HJHS, Haemophilia Joint Health Score.
FIGURE 2
FIGURE 2
HJHS and HEAD‐US joint health scores from baseline to 12 months. Figures show mean (triangle), median (line splitting the box), IQR (box boundaries) and maximum/minimum values (whiskers); thick red lines indicate equal medians/quartiles. aMissing data for n = 2 at baseline, n = 5 at 6 months and n = 6 at 12 months. bMissing data for n = 2 at baseline, n = 7 at 6 months and n = 6 at 12 months. HEAD‐US, Haemophilia Early Arthropathy Detection with Ultrasound; HJHS, Haemophilia Joint Health Score; IQR, interquartile range.
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