title: The effect of secondary prophylaxis versus episodic treatment on the range of motion of target joints in patients with haemophilia.
abstract: This study prospectively compared the effect of secondary prophylaxis to episodic treatment on target joint (TJ) range of motion (ROM), number of joint haemorrhages and new TJ development in patients with moderate or severe haemophilia. Two-hundred and eighty-six males, 17% in prophylaxis, 83% in episodic treatment group, participating in the Centers for Disease Control and Prevention's Universal Data Collection project, fulfilled inclusion criteria: age >2 years at enrollment, free of TJs at enrollment, developed at least one TJ after enrollment, and received either prophylaxis or episodic treatment continuously for two follow-up visits after TJ development. The outcomes of interest - percentage change in TJ ROM, number of joint haemorrhages and new TJ development, were modelled using multivariate linear, Poisson and logistic regression techniques respectively. Individuals who received secondary prophylaxis in comparison to episodic treatment were younger at TJ development (P < 0.01); there was no difference in the decrease in TJ ROM between the two groups (P = 0.9). Factors significantly associated with a higher rate of haemarthroses included episodic treatment, severe haemophilia, age >5 years at TJ development, obesity and inhibitor negative status. Secondary prophylaxis significantly decreased haemarthroses but was not associated with a significant improvement in TJ ROM or with new TJ development.
authors: Indiana Hemophilia and Thrombosis Center, Indianapolis, IN 46260, USA. sgupta@ihtc.org
authors: Sweta
authors: S
authors: Gupta
authors: Azfar-E-Alam
authors: AE
authors: Siddiqi
authors: J Michael
authors: JM
authors: Soucie
authors: Marilyn
authors: M
authors: Manco-Johnson
authors: Roshni
authors: R
authors: Kulkarni
authors: Heidi
authors: H
authors: Lane
authors: Robina
authors: R
authors: Ingram-Rich
authors: Joan C
authors: JC
authors: Gill
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005164:Factor IX / Q000276:immunology / Q000627:therapeutic use; D005169:Factor VIII / Q000276:immunology / Q000627:therapeutic use; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology; D006395:Hemarthrosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control* / Q000534:rehabilitation; D006467:Hemophilia A / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007518:Isoantibodies / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D016059:Range of Motion, Articular; D011994:Recombinant Proteins / Q000276:immunology / Q000627:therapeutic use; D020127:Recovery of Function; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
chemical_list: D007518:Isoantibodies; D011994:Recombinant Proteins; D005169:Factor VIII; D005164:Factor IX