Joint health and pain in the changing hemophilia treatment landscape

ABSTRACT

Introduction

Hemophilia is an inherited bleeding disorder. Bleeding, and in particular joint hemorrhage results in chronic arthropathy and disability. Acute and chronic pain are frequent and limit activity and participation and result in decreased health-related quality of life. Remarkable progress has been made in the diagnosis and treatment of hemophilia but bleeding continues to prove recalcitrant to currently available treatments and joint disease remains problematic. Physiotherapy and pain management are mainstays of current multidisciplinary integrated care of people with hemophilia (PWH). The focus of this review is on preservation of joint health in the era of new and innovative therapies.

Areas covered

A search of the PubMed Central was conducted on 1 February 2024 using the MeSH Major Topic terms identified as keywords for the manuscript. This review will highlight what is known and unknown about joint bleeding and arthropathy, including insights on pain as a related complication.

Expert opinion

Recent advances in therapeutic interventions aimed at promoting healthy joints in PWH will be discussed, including both the pharmacological treatment landscape and related strategies to promote joint health.

KEYWORDS:

• Arthropathy
• bleeding
• hemophilia
• joints
• pain
• physiotherapy
• treatment
• synovitis

Article highlights

• Pain and joint bleeding continue to be significant problems for people with hemophilia.

• Innovations in treatment have improved the outcomes for people with hemophilia.

• Equitable outcomes for all people with hemophilia, including women, throughout the world is the goal.

• Multiple areas are highlighted in which research and innovation is needed.

Declaration of interest

ME Mancuso has acted as a paid consultant/speaker/advisor for Bayer HealthCare, Biomarin Pharmaceutical, CSL Behring, Grifols, Kedrion, LFB, Novo Nordisk, Octapharma, Roche, Sanofi, Sobi, Spark Therapeutics, Takeda, and UniQure. P McLaughlin has acted as a paid consultant/speaker/advisor for CSL Behring, Novo Nordisk, Sobi, and Sanofi, and has received research grant funding from Novo Nordisk and Sobi. AL Forsyth is a full-time employee at Optum Infusion Pharmacy and Director of the Optum Physical Therapy Collaborative. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors wish to thank Michael Recht for his careful review and thoughtful comments for the improvement of this manuscript.

Additional information

Funding

This paper was not funded.