Emerging clinical concerns in the ageing haemophilia patient.
The availability of safe replacement clotting factor concentrates together with effective antiviral drugs to treat human immunodeficiency and hepatitis C viruses and the provision of care at designated haemophilia treatment centres have resulted in a new phenomenon in haemophilia management - the ageing patient. Today, increasing numbers of persons with haemophilia (PWH) are middle-aged and older, and they face the same age-related health issues as the general population. The impact of these risks on PWH is unclear, however, and there is a paucity of information about how to manage comorbidities in this patient population. This review focuses on five comorbidities that uniquely affect older PWH: cardiovascular disease, liver disease, cancer, renal disease and joint disease. Available research is summarized and potential management approaches are suggested.
Konkle
B A
BA
Penn Comprehensive Hemophilia Program, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. barbara.konkle@uphs.upenn.edu
Kessler
C
C
Aledort
L
L
Andersen
J
J
Fogarty
P
P
Kouides
P
P
Quon
D
D
Ragni
M
M
Zakarija
A
A
Ewenstein
B
B
D000368:Aged; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D005169:Factor VIII / Q000627:therapeutic use; D006467:Hemophilia A / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D008107:Liver Diseases / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D018570:Risk Assessment
D001779:Blood Coagulation Factors; D005169:Factor VIII