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Zhang L, Zhang P, Chen W. Overview of Patients with Hemophilia in China: Demographics, Diseases, Treatment, and Health Status. Patient Prefer Adherence 2024; 18:101-109. [PMID: 38234633 PMCID: PMC10793115 DOI: 10.2147/ppa.s441873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/06/2024] [Indexed: 01/19/2024] Open
Abstract
Background In China, there were over 65,000 hemophilia patients according to estimations requiring overall description. However, former Chinese studies related to hemophilia were based on data of relatively small sample size from single-center or selected multi-centers in specific areas. Objective This study is aimed to provide an overview of patients with hemophilia in China and basic information for optimized hemophilia care and policy decisions in the future. Methods We cooperated with the biggest patient organization of hemophilia in China, Hemophilia Home, got access to over ten thousand registered patients with hemophilia and conducted a national representative online survey in 2021. Descriptive statistics were conducted to describe the mean and standard deviation for continuous variables and numbers and proportions for categorical variables. Results Nine hundred and fifty patients with hemophilia aged 0-71 years were included in our analysis and divided into 538 children and 412 adults. Compared to international research, consistent results were found regarding the proportions of hemophilia types and hemophilia severity, while Chinese patients had less opportunity to receive the formal education and the lower rate to be employed or married. Although children with hemophilia had higher household income, timely treatment, and more prophylaxis treatment leading to better clinical outcomes and higher HRQoL than adults, there were still more annual bleeds, chronic pains, and lower EQ-VAS scores especially in adults than in other countries. Conclusions and Recommendation Our findings suggest the urgency for promoting hemophilia care and improving the social adaptation of hemophilia patients in China.
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Affiliation(s)
- Luying Zhang
- School of Public Health, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Peng Zhang
- School of Humanities, Shanghai Institute of Technology, Shanghai, 201418, People’s Republic of China
| | - Wen Chen
- School of Public Health, Fudan University, Shanghai, 200032, People’s Republic of China
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Ransmann P, Krüger S, Hilberg T, Hagedorn T, Roussel N. Prevalence of pain in adult patients with moderate to severe haemophilia: a systematic review. Scand J Pain 2022; 22:436-444. [PMID: 35297228 DOI: 10.1515/sjpain-2021-0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/17/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Patients with haemophilia (PwH) often suffer from joint pain due to repetitive haemarthroses and resulting arthropathy. Literature focuses so far on pain causes, diagnosis or treatment. A summary of prevalence rates, providing facts on the absolute occurrence of pain, is not sufficiently described so far. This review aimed to explore and systematically review different pain conditions, focussing on prevalence rates of pain in adult PwH. METHODS A review of English articles using PubMed and Web of Science was conducted in February 2020. The search strategy included patients with haemophilia A or B suffering from pain. The articles were selected based on defined PICOS-selection criteria. RESULTS Out of 606 identified articles, 13 studies matched the given eligibility criteria and indicated pain prevalence rates. The weighted mean (WM) for the prevalence rate (varying timeframes) for chronic pain was 40% whereas for point prevalence the rate was WM=75%. Regarding pain intensity, findings of the EQ-5D-3L revealed moderate pain to be more present (61.0%) compared to extreme (11.6%). The main problem was the inconsistency of the definition of both acute and chronic pain as well as for prevalence types. CONCLUSIONS Pain is a major problem in patients with haemophilia. Pain therapy should be carried out taking into account the difference between bleeding-related or arthropathy-related causes of pain. In addition, the intensity and duration of pain should be recorded consistently to better monitor therapy and allow comparison with existing data.
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Affiliation(s)
- Pia Ransmann
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Steffen Krüger
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Thorsten Hagedorn
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Nathalie Roussel
- Department of Rehabilitation Science and Physiotherapy (MOVANT), University of Antwerp, Wilrijk, Belgium
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Kennedy M, O' Mahony B, Roche S, McGowan M, Singleton E, Ryan K, O' Connell NM, Pipe SW, Lavin M, O' Donnell JS, Turecek PL, Gormley J. Pain and functional disability amongst adults with moderate and severe haemophilia from the Irish personalised approach to the treatment of haemophilia (iPATH) study. Eur J Haematol Suppl 2022; 108:518-527. [PMID: 35258118 PMCID: PMC9311204 DOI: 10.1111/ejh.13763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 12/15/2022]
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.
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Affiliation(s)
- Megan Kennedy
- Discipline of Physiotherapy, Trinity Centre for Health Sciences, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
| | | | - Sheila Roche
- National Coagulation Centre, St. James's Hospital, Dublin, Ireland
| | - Mark McGowan
- National Coagulation Centre, St. James's Hospital, Dublin, Ireland
| | - Evelyn Singleton
- National Coagulation Centre, St. James's Hospital, Dublin, Ireland
| | - Kevin Ryan
- National Coagulation Centre, St. James's Hospital, Dublin, Ireland
| | | | - Steven W Pipe
- Departments of Pediatrics and Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Michelle Lavin
- National Coagulation Centre, St. James's Hospital, Dublin, Ireland.,Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - James S O' Donnell
- National Coagulation Centre, St. James's Hospital, Dublin, Ireland.,Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Peter L Turecek
- Baxalta Innovations GmbH, A Member of the Takeda Group of Companies, Vienna, Austria
| | - John Gormley
- Discipline of Physiotherapy, Trinity Centre for Health Sciences, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
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Cortesi PA, Rocino A, Preti D, Fragomeno A, Cucuzza F, Ceresi N, Santoro C, Ferretti A, Fornari A, Antonazzo IC, Facchetti R, Cozzolino P, Biasoli C, Cassone C, Coppola A, Mantovani LG. Haemophilia management and treatment: An Italian survey on patients’, caregivers’ and clinicians’ point of view. Haemophilia 2022; 28:254-263. [DOI: 10.1111/hae.14504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/13/2022] [Accepted: 01/24/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Paolo Angelo Cortesi
- Research Centre on Public Health (CESP) University of Milano‐Bicocca Monza Italy
- IRCCS Multimedica Sesto San Giovanni Italy
| | - Angiola Rocino
- UOC di Ematologia ‐ Centro Emofilia e Trombosi Ospedale del Mare ‐ ASL NA1 Napoli Italy
| | - Daniele Preti
- Italian Federation of Haemophilia Associations (FedEmo) Rome Italy
| | - Anna Fragomeno
- Italian Federation of Haemophilia Associations (FedEmo) Rome Italy
| | | | - Nicola Ceresi
- Italian Federation of Haemophilia Associations (FedEmo) Rome Italy
| | | | | | - Arianna Fornari
- Research Centre on Public Health (CESP) University of Milano‐Bicocca Monza Italy
| | | | - Rita Facchetti
- Research Centre on Public Health (CESP) University of Milano‐Bicocca Monza Italy
| | | | - Chiara Biasoli
- Hemophilia Center and Transfusion Department Hospital of Cesena Cesena Italy
| | - Cristina Cassone
- Italian Federation of Haemophilia Associations (FedEmo) Rome Italy
| | - Antonio Coppola
- Regional Reference Center for Inherited Bleeding Disorders University Hospital of Parma Parma Italy
| | - Lorenzo G. Mantovani
- Research Centre on Public Health (CESP) University of Milano‐Bicocca Monza Italy
- IRCCS Multimedica Sesto San Giovanni Italy
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Banchev A, Batorova A, Faganel Kotnik B, Kiss C, Puras G, Zapotocka E, Zupancic-Salek S. A Cross-National Survey of People Living with Hemophilia: Impact on Daily Living and Patient Education in Central Europe. Patient Prefer Adherence 2021; 15:871-883. [PMID: 33953547 PMCID: PMC8091596 DOI: 10.2147/ppa.s303822] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/30/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Information about the impact of hemophilia on daily living and information preferences for patients and their caregivers in Central Europe has been limited. METHODS This cross-national survey was conducted between April 1 and October 15, 2020 and utilized a self-administered questionnaire to collect data (Typeform™) from people living with hemophilia in Bulgaria, Croatia, Czech Republic, Hungary, Slovakia and Slovenia. The questionnaire included 22 questions regarding difficulties in daily life and preferences for receiving hemophilia-related information. Respondents were stratified into two main groups, people with hemophilia (PwH) or their caregivers (CPwH). Results were analyzed using descriptive statistics. RESULTS Of the 364 respondents, 232 were PwH (63.7%) and 132 were CPwH (36.3%). In total, 70.3% of hemophilia patients/caregivers responded that they are kept sufficiently informed about life with hemophilia, with 68.0%, 59.1% and 56.3% of respondents obtaining information from their physicians, patient associations and via digital media (internet and social media), respectively. However, 97.8% of respondents expressed an interest in additional information, particularly new hemophilia treatment options (62.1%), which in contrast to other topics was indicated most frequently by both patients and caregivers in all six countries. Most frequent difficulties in everyday life with hemophilia were identified as mobility problems (41.8%), unexpected bleeding (38.5%), pain (35.4%), and uncertainty with what they can or cannot do (25.0%). During the 2020 COVID-19 pandemic, 52.5% of respondents reported that they did not experience any major change in daily living with hemophilia. CONCLUSION Based on our Central European survey, hemophilia mostly affects peoples' lives by causing mobility difficulties, unexpected bleeding, pain and uncertainty in daily activities. Although the majority of respondents reported being educated about hemophilia, most PwH and CPwH respondents sought additional information, highlighting the need for continuous personalized patient education to cope with present challenges.
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Affiliation(s)
- Atanas Banchev
- Department of Pediatric Hematology and Oncology, University Hospital ‘Tzaritza Giovanna – ISUL’, Sofia, Bulgaria
| | - Angelika Batorova
- National Hemophilia Center, Department of Hematology and Transfusion Medicine, Faculty of Medicine of Comenius University and University Hospital, Bratislava, Slovakia
| | - Barbara Faganel Kotnik
- Department of Oncology and Hematology, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Csongor Kiss
- Department of Pediatric Hematology-Oncology, Institute of Pediatrics, University of Debrecen, Debrecen, Hungary
| | - Gediminas Puras
- Department of Medical Affairs CEER, Swedish Orphan Biovitrum AG, Basel, Switzerland
| | - Ester Zapotocka
- Department of Pediatric Hematology/Oncology, University Hospital Motol, Prague, Czech Republic
| | - Silva Zupancic-Salek
- Department of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
- Correspondence: Silva Zupancic-Salek Department of Medicine, University Hospital Centre Zagreb, Rebro, Kispatic Str 12, Zagreb, 10 000, CroatiaTel +385 1 337 5199Fax +385 1 332 4650 Email
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Beny K, du Sartz de Vigneulles B, Chamouard V, Guilloux R, Gay V, Negrier C, Dussart C. Patients' Perception of the Impact of Innovation on Hemophilia Care Management Organization: A Qualitative Study Protocol (INNOVHEMO Study). Patient Prefer Adherence 2021; 15:1807-1815. [PMID: 34434044 PMCID: PMC8380624 DOI: 10.2147/ppa.s322531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/21/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND New therapies provide a favorable evolution in the care management of persons with hemophilia. However, the impact of these new therapies on patient care organization remains to be determined. A qualitative study will be implemented to analyze patients' perception regarding the impact of innovation on the organization of their care management. Secondary objectives will include refining specific factors related to persons with hemophilia (barriers or facilitators, especially the place of treatment) to consider within an organizational impact analysis. PATIENTS AND METHODS Semi-structured individual interviews will be conducted via videoconferencing or by phone by two researchers using an interview guide. Participants will be recruited from the Rhône-Alpes region, in France. Physicians from two hemophilia treatment centers will identify eligible patients. Moreover, a call for volunteers will be launched by the Rhône-Alpes committee of the French hemophilia association. Interviews will be conducted with adult patients, adolescent patients or parents of a minor with hemophilia regularly treated prophylactically or on demand. Data analysis will be performed with NVivo® software. Each interview will be analyzed by two researchers using an inductive content analytic method. DISCUSSION The INNOVHEMO study is an original study analyzing the way patients perceive the impact of an innovation on their care management organization. The resulting patient-specific factors, identified as barriers or facilitators, will need to be integrated into a more comprehensive analysis of the impact of innovation on care management organization.
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Affiliation(s)
- Karen Beny
- EA 4129 Laboratory P2S (Health Systemic Process), University of Lyon, University Claude Bernard Lyon 1, Lyon, France
- Central Pharmacy, Hospices Civils de Lyon, Lyon, France
- Correspondence: Karen Beny Central Pharmacy, Hospices Civils de Lyon, 57 rue Francisque Darcieux, CS 60004, 69563 Saint Genis Laval Cedex, Lyon, FranceTel +33 4 78 86 66 92Fax +33 4 72 67 88 74 Email
| | | | - Valerie Chamouard
- Reference center on hemophilia and other constitutional hemorrhagic diseases, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
- Pharmacy, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - Ronald Guilloux
- Laboratory S2HEP, University of Lyon, University Claude Bernard Lyon 1, Lyon, France
| | - Valérie Gay
- Hemophilia Care Center, Centre hospitalier Métropole Savoie, Chambéry, France
| | - Claude Negrier
- Reference center on hemophilia and other constitutional hemorrhagic diseases, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - Claude Dussart
- EA 4129 Laboratory P2S (Health Systemic Process), University of Lyon, University Claude Bernard Lyon 1, Lyon, France
- Central Pharmacy, Hospices Civils de Lyon, Lyon, France
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Reiss UM, Zhang L, Ohmori T. Hemophilia gene therapy-New country initiatives. Haemophilia 2020; 27 Suppl 3:132-141. [PMID: 32638467 DOI: 10.1111/hae.14080] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 12/12/2022]
Abstract
Gene therapy is an opportunity for haemophilia patients to receive a one-time treatment and have lasting factor levels for years or decades instead of dependence on repeated administration within short intervals and on sustained supply of drug. Great strides have been made in the development of gene therapy for haemophilia in the last decade. Adeno-associated virus (AAV) vector-mediated gene transfer in haemophilia A and B has entered the phase III trial stage. Gene transfer by lentiviral vector or gene editing technologies using factor VIII (FVIII) or IX (FIX) genes are now entering clinical evaluation. It is expected that the first FVIII and FIX gene therapy products will soon be approved and distributed in major markets. Global access to gene therapy is a critical goal. This review presents new and ongoing efforts towards this goal in countries other than North America and Europe. In Japan, researchers, regulators and funders have established a promising gene therapy development platform for multiple diseases including haemophilia. Decades of scientific and clinical research in haemophilia gene therapy in China have led to a recently registered clinical trial of AAV-mediated gene therapy for haemophilia B. Other countries are in earlier phases of building gene therapy programmes or participate in international trials. A phase 2 feasibility trial of AAV-mediated FIX gene therapy in low- and middle-income countries aims to demonstrate that gene therapy could become available in resource-constrained socio-economic settings. The different strategies for establishing gene therapy provide opportunities for closing the global gap in haemophilia care.
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Affiliation(s)
- Ulrike M Reiss
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Lei Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin Key Laboratory of Blood Disease Gene Therapy, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Tsukasa Ohmori
- Department of Biochemistry, Jichi Medical University School of Medicine, Shimotsuke, Japan
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