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Oomen I, Verhagen M, Miranda M, Allacher P, Beckers EAM, Blijlevens NMA, van der Bom JG, Coppens M, Driessens M, Eikenboom JCJ, Fijnvandraat K, Hassan S, van Heerde WL, Hooimeijer HL, Jansen JH, Kaijen P, Leebeek FWG, Meijer D, Paul H, Rijpma SR, Rosendaal FR, Smit C, van Vulpen LFD, Voorberg J, Schols SEM, Gouw SC. The spectrum of neutralizing and non-neutralizing anti-FVIII antibodies in a nationwide cohort of 788 persons with hemophilia A. Front Immunol 2024; 15:1355813. [PMID: 38455035 PMCID: PMC10918462 DOI: 10.3389/fimmu.2024.1355813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/22/2024] [Indexed: 03/09/2024] Open
Abstract
Objectives Anti-factor VIII (FVIII) antibodies have been reported to exhibit both neutralizing and non-neutralizing characteristics. This is the first study investigating the full spectrum of FVIII-specific antibodies, including non-neutralizing antibodies, very-low titer inhibitors, and inhibitors, in a large nationwide population of persons with hemophilia A of all severities. Methods All persons with hemophilia A (mild (FVIII > 5-40 IU/dL)/moderate [FVIII 1-5 IU/dL)/severe (FVIII < 1 IU/dL)] with an available plasma sample who participated in the sixth Hemophilia in the Netherlands study between 2018 and 2019 were included. The presence of anti-FVIII antibodies of the immunoglobulin A, M, and G isotypes and IgG subclasses, along with antibody titer levels, were assessed using direct-binding ELISAs. FVIII specificity was assessed using a competition-based ELISA approach. The inhibitor status was determined using the Nijmegen ultra-sensitive Bethesda assay (NusBA) and the Nijmegen Bethesda assay (NBA). Results In total, 788 persons with hemophilia A (336 (42.6%) mild, 123 (15.6%) moderate, 329 (41.8%) severe hemophilia) were included. The median age was 45 years (IQR 24-60), and the majority (50.9%) had over 150 exposure days to FVIII concentrates. Within our population, 144 (18.3%) individuals had non-neutralizing FVIII-specific antibodies, 10 (1.3%) had very low-titer inhibitors (NusBA positive; NBA negative), and 13 (1.6%) had inhibitors (both NusBA and NBA positive). IgG1 was the most abundant FVIII-specific antibody subclass, and the highest titer levels were found for IgG4. In individuals without a reported history of inhibitor development, no clear differences were observed in antibody patterns between those who were minimally or highly exposed to FVIII concentrates. IgG4 subclass antibodies were only observed in persons with a reported history of FVIII inhibitor or in those with a currently detected (very low-titer) inhibitor. Conclusion In this cross-sectional study, we identified non-neutralizing antibodies in a relatively large proportion of persons with hemophilia A. In contrast, in our population, consisting of persons highly exposed to FVIII concentrates, (very low-titer) inhibitors were detected only in a small proportion of persons, reflecting a well-tolerized population. Hence, our findings suggest that only a small subpopulation of non-neutralizing FVIII-specific antibodies is associated with clinically relevant inhibitors.
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Affiliation(s)
- Ilja Oomen
- Department of Pediatric Hematology, Amsterdam University Medical Center (UMC) Location University of Amsterdam, Amsterdam, Netherlands
- Department of Molecular Hematology, Sanquin Research, Amsterdam, Netherlands
| | - Marieke Verhagen
- Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands
- Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, Netherlands
- Laboratory of Hematology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Peter Allacher
- Institute Krems Bioanalytics, International Management Center (IMC) University of Applied Sciences Krems, Krems, Austria
| | - Erik A. M. Beckers
- Division of Hematology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht University, Maastricht, Netherlands
| | - Nicole M. A. Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands
- Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, Netherlands
| | - Johanna G. van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, Location University of Amsterdam, Amsterdam, Netherlands
| | | | - Jeroen C. J. Eikenboom
- Division of Thrombosis and Hemostasis, Department of Internal Medicine, Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Amsterdam University Medical Center (UMC) Location University of Amsterdam, Amsterdam, Netherlands
- Department of Molecular Hematology, Sanquin Research, Amsterdam, Netherlands
| | - Shermarke Hassan
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
- Infectious Diseases Data Observatory, Center for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Waander L. van Heerde
- Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands
- Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, Netherlands
- Enzyre BV, Nijmegen, Netherlands
| | - H. Louise Hooimeijer
- Division of Hematology/Oncology, Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Joop H. Jansen
- Laboratory of Hematology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Paul Kaijen
- Department of Molecular Hematology, Sanquin Research, Amsterdam, Netherlands
| | - Frank W. G. Leebeek
- Department of Hematology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Daniëlle Meijer
- Laboratory of Hematology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Helmut Paul
- Institute Krems Bioanalytics, International Management Center (IMC) University of Applied Sciences Krems, Krems, Austria
| | - Sanna R. Rijpma
- Laboratory of Hematology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Frits R. Rosendaal
- Division of Thrombosis and Hemostasis, Department of Internal Medicine, Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | - Cees Smit
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, Location University of Amsterdam, Amsterdam, Netherlands
- Division of Thrombosis and Hemostasis, Department of Internal Medicine, Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | - Lize F. D. van Vulpen
- Center for Benign Hematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Utrecht, Netherlands
| | - Jan Voorberg
- Department of Molecular Hematology, Sanquin Research, Amsterdam, Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Saskia E. M. Schols
- Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands
- Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, Netherlands
| | - Samantha C. Gouw
- Department of Pediatric Hematology, Amsterdam University Medical Center (UMC) Location University of Amsterdam, Amsterdam, Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
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2
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Verhagen MJA, van Balen EC, Blijlevens NMA, Coppens M, van Heerde WL, Leebeek FWG, Rijpma SR, van Vulpen LFD, Gouw SC, Schols SEM. Patients with moderate hemophilia A and B with a severe bleeding phenotype have an increased burden of disease. J Thromb Haemost 2024; 22:152-162. [PMID: 37813197 DOI: 10.1016/j.jtha.2023.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/13/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Patients with moderate hemophilia express varying bleeding phenotypes. OBJECTIVES To assess the burden of disease in patients with moderate hemophilia and a mild or severe phenotype incorporating the thrombin generation profile. METHODS This sub-study of the 6th Hemophilia in the Netherlands study, analyzed data of adults with moderate hemophilia A or B. Patient characteristics and information on bleeding tendency, joint status, and quality of life were obtained from electronic patient files and self-reported questionnaires. A severe bleeding phenotype was defined as an annual bleeding rate ≥5, an annual joint bleeding rate ≥3, and/or the use of secondary/tertiary prophylaxis, and a mild phenotype vice versa. TG was measured with the Nijmegen Hemostasis Assay. RESULTS This study included 116 patients: 21% had a severe phenotype of whom 46% used prophylaxis. Patients with a severe phenotype treated on demand reported a higher median annual bleeding rate (7), annual joint bleeding rate (3), and more frequently an impaired joint (77%) than patients with a severe phenotype on prophylaxis (2; 0; 70%) or patients with a mild phenotype (0; 0; 47%). Furthermore, patients with a severe phenotype treated on demand experienced a more decreased quality of life. Despite similar factor activity levels, patients with a severe phenotype had a lower thrombin peak height and thrombin potential (0.7%; 0.06%) than patients with a mild phenotype (21.3%; 46.8%). CONCLUSION Patients with moderate hemophilia and a severe phenotype treated on demand displayed a high burden of disease as well as a low thrombin generation profile advocating them toward more intensive prophylactic treatment.
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Affiliation(s)
- Marieke J A Verhagen
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands; Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, the Netherlands; Department of Laboratory Medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Erna C van Balen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine and Haemophilia Treatment Center, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Waander L van Heerde
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands; Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, the Netherlands; Enzyre BV, Novio Tech Campus, Nijmegen, the Netherlands
| | - Frank W G Leebeek
- Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Sanna R Rijpma
- Department of Laboratory Medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lize F D van Vulpen
- Center for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Samantha C Gouw
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; Amsterdam UMC Location University of Amsterdam, Department of Pediatric Hematology, Meibergdreef 9, Amsterdam, the Netherlands
| | - Saskia E M Schols
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands; Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, the Netherlands.
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3
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Nassar-Sheikh Rashid A, Bergkamp SC, Kampinga RE, Gouw SC, Bouts AHM, Oosterveld MJS, Baars PA, van Leeuwen EMM, Kuijpers TW, van den Berg JM, Schonenberg-Meinema D. Pharmacodynamics of rituximab in paediatric immune mediated diseases: B cell depletion and repopulation, effects on immunoglobulin levels and risk for infections. Clin Exp Rheumatol 2023; 41:2323-2330. [PMID: 37470239 DOI: 10.55563/clinexprheumatol/yqjz1s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/24/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVES Rituximab (RTX), used for treatment in paediatric immune-mediated diseases, can lead to hypogammaglobulinaemia and thus to an increased risk of infection, but data on these adverse effects in children are scarce. We aimed to describe the pharmacodynamics of RTX by time to B cell repopulation in paediatric immune-mediated diseases and to assess whether low post-RTX immunoglobulin levels were associated with frequency and severity of infections. METHODS Data of children with autoimmune diseases (AID), immune dysregulation (ID), haematological diseases (HD) and renal diseases (RD), including immunoglobulin levels pre-/post-RTX and occurrence of infections, who had received RTX at our centre were retrospectively collected. B cell depletion was defined as B cells <10 cells/μl. RESULTS Post-RTX B cell depletion was achieved in 45/49 patients. In 30/45 patients with B cell repopulation, median time to repopulation was 166 days (IQR 140-224): AID group (n=9) (183 days (IQR 156-239), ID group (n=6) 170 days (IQR 128-184), HD group (n=7) 139 days (IQR 127-294), RD group (n=7) 160 days (IQR 121-367). Severe infections leading to hospitalisation occurred in 7/52 (13.5%) patients: ID (n=3), HD (n=1), RD (n=3). After RTX treatment, 13/52 patients (25%) had low IgG levels for their age at least once, 11/13 had an infection during low IgG but only 2/13 had a severe infection. Low IgG was not associated with severe infection (p=0.459). CONCLUSIONS Time to B cell repopulation post-RTX ranged individually but did not significantly differ between paediatric patient groups. Severe infections were non-frequent and not associated with low (post-RTX) IgG levels.
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Affiliation(s)
- Amara Nassar-Sheikh Rashid
- Department of Paediatric Immunology, Rheumatology and Infectious Diseases, Amsterdam UMC location University of Amsterdam; and Department of Paediatrics, Zaans Medical Center, Zaandam, The Netherlands.
| | - Sandy C Bergkamp
- Department of Paediatric Immunology, Rheumatology and Infectious Diseases, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Rosanne E Kampinga
- Department of Paediatric Immunology, Rheumatology and Infectious Diseases, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Samantha C Gouw
- Department of Paediatric Haematology, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Antonia H M Bouts
- Department of Paediatric Nephrology, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Michiel J S Oosterveld
- Department of Paediatric Nephrology, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Paul A Baars
- Department of Experimental Immunology, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Esther M M van Leeuwen
- Department of Experimental Immunology, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Taco W Kuijpers
- Department of Paediatric Immunology, Rheumatology and Infectious Diseases, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - J Merlijn van den Berg
- Department of Paediatric Immunology, Rheumatology and Infectious Diseases, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Dieneke Schonenberg-Meinema
- Department of Paediatric Immunology, Rheumatology and Infectious Diseases, Amsterdam UMC location University of Amsterdam, The Netherlands
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4
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van Hoorn ES, Lingsma HF, Cnossen MH, Gouw SC. Patient-relevant health outcomes for von Willebrand disease, platelet function disorders, and rare bleeding disorders: a Delphi study. Res Pract Thromb Haemost 2023; 7:102201. [PMID: 37854454 PMCID: PMC10579528 DOI: 10.1016/j.rpth.2023.102201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/04/2023] [Accepted: 08/25/2023] [Indexed: 10/20/2023] Open
Abstract
Background To assess patient value, it is essential to regularly measure health outcomes that matter to patients. It is currently unknown which health outcomes are important for patients with autosomal inherited bleeding disorders. Objectives This study aimed to assess which health outcomes are important for patients with autosomal inherited bleeding disorders, consisting of von Willebrand disease, platelet function disorders, and rare bleeding disorders, as seen from the patients', caregivers', and healthcare professionals' perspectives. Methods Two panels, one consisting of patients and caregivers, and one consisting of healthcare professionals participated in a Delphi process. A list of 146 health outcomes was identified from the literature. During 3 rounds, both panels rated the importance of health outcomes on a 5-point Likert scale. A health outcome was considered important by a panel if it received a median score of 5 with an IQR of ≤1. Results In total, 13 patients, 10 caregivers, and 19 healthcare professionals participated in the Delphi study. Both panels reached consensus on the importance of health outcomes related to bleeding episodes, life-threatening complications, and the intensity and impact of menstruation. Patients and caregivers additionally reached consensus on the importance of health outcomes related to menstruation and the impact of the bleeding disorder on their daily lives. Healthcare professionals reached consensus on the importance of health outcomes related to treatment, joint health, and pain. Conclusion In this study, health outcomes were identified that should be considered when implementing value-based health care in the care of patients with autosomal inherited bleeding disorders.
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Affiliation(s)
- Evelien S. van Hoorn
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hester F. Lingsma
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marjon H. Cnossen
- Department of Pediatric Hematology and Oncology, Sophia Children’s Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Samantha C. Gouw
- Department of Pediatric Hematology, Amsterdam University Medical Centers location University of Amsterdam, Amsterdam, The Netherlands
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5
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Brands MR, Janssen EAM, Cnossen MH, Smit C, van Vulpen LFD, van der Valk PR, Eikenboom J, Heubel-Moenen FCJI, Hooimeijer L, Ypma P, Nieuwenhuizen L, Coppens M, Schols SEM, Laros-van Gorkom BAP, Leebeek FWG, Driessens MHE, Rosendaal FR, van der Bom JG, Fijnvandraat K, Gouw SC. Transition readiness among adolescents and young adults with haemophilia in the Netherlands: Nationwide questionnaire study. Haemophilia 2023; 29:1191-1201. [PMID: 37602825 DOI: 10.1111/hae.14834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/14/2023] [Accepted: 07/24/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION Care for adolescents with haemophilia is transferred from paediatric to adult care around the age of 18 years. Transition programs help to prepare adolescents for this transfer and prevent declining treatment adherence. Evaluating transition readiness may identify areas for improvement. OBJECTIVE Assess transition readiness among Dutch adolescents and young adults with haemophilia, determine factors associated with transition readiness, and identify areas of improvement in transition programs. METHODS All Dutch adolescents and young adults aged 12-25 years with haemophilia were invited to participate in a nationwide questionnaire study. Transition readiness was assessed using multiple-choice questions and was defined as being ready or almost ready for transition. Potential factors associated with transition readiness were investigated, including: socio-demographic and disease-related factors, treatment adherence, health-related quality of life, and self-efficacy. RESULTS Data of 45 adolescents and 84 young adults with haemophilia (47% with severe haemophilia) were analyzed. Transition readiness increased with age, from 39% in 12-14 year-olds to 63% in 15-17 year-olds. Nearly all post-transition young adults (92%, 77/84) reported they were ready for transition. Transition readiness was associated with treatment adherence, as median VERITAS-Pro treatment adherence scores were worse in patients who were not ready (17, IQR 9-29), compared to those ready for transition (11, IQR 9-16). Potential improvements were identified: getting better acquainted with the adult treatment team prior to transition and information on managing healthcare costs. CONCLUSIONS Nearly all post-transition young adults reported they were ready for transition. Improvements were identified regarding team acquaintance and preparation for managing healthcare costs.
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Affiliation(s)
- Martijn R Brands
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Ebony A M Janssen
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Marjon H Cnossen
- Department of Pediatric Hematology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Cees Smit
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Lize F D van Vulpen
- Center for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Paul R van der Valk
- Center for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jeroen Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Louise Hooimeijer
- Department of Pediatrics, University Medical Center Groningen, Groningen, the Netherlands
| | - Paula Ypma
- Department of Hematology, HagaZiekenhuis, The Hague, the Netherlands
| | | | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Pulmonary Hypertension & Thrombosis, Amsterdam, The Netherlands
| | - Saskia E M Schols
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
- Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, the Netherlands
| | - Britta A P Laros-van Gorkom
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
- Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, the Netherlands
| | - Frank W G Leebeek
- Department of Hematology, Erasmus MC, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Johanna G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, the Netherlands
| | - Samantha C Gouw
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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Teela L, Luijten MA, Kuijlaars IA, van Gastel TC, van Hoorn ES, Gouw SC, Fijnvandraat KC, Fischer K, Cnossen MH, Andeweg S, van der Velden – van ‘t Hoff C, Liem C, Jansen-Zijlstra ME, Peters M, Haverman L. Psychometrics of the patient-reported outcomes measurement information system measures in hemophilia: the applicability of the pediatric item banks. Res Pract Thromb Haemost 2023; 7:102159. [PMID: 37753226 PMCID: PMC10518485 DOI: 10.1016/j.rpth.2023.102159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 09/28/2023] Open
Abstract
Background The use of patient-reported outcomes measures (PROMs) is important in hemophilia care, as it facilitates communication between patients and clinicians and promotes patient-centered care. Currently, a variety of PROMs with insufficient psychometric properties are used. Patient-reported outcomes measurement information system (PROMIS) measures, including Computer Adaptive Tests, were designed to measure generically and more efficiently and, therefore, are an alternative for the existing PROMs. Objectives To assess the feasibility, measurement properties, and outcomes of 8 PROMIS pediatric measures for boys with hemophilia. Methods In this multicenter study, boys with hemophilia completed 8 PROMIS measures and 2 legacy instruments. Feasibility was determined by the number of completed items and floor or ceiling effects (percentage of participants that achieved the lowest or highest possible score). Reliability was assessed as the percentage of scores with a SE ≤ 4.5. Construct validity was evaluated by comparing the PROMIS measures with the legacy instruments. Mean PROMIS T-scores were calculated and compared with the Dutch general population. Results In total, 77 boys with hemophilia participated. Reliability was good for almost all PROMIS measures and legacy instruments. The total number of completed items varied from 49 to 90 for the PROMIS pediatric measures, while the legacy instruments contained 117 to 130 items. Floor and ceiling effects were observed in both the PROMIS measures (0-39.5%) and legacy instruments (0-66.7%), but were higher for the legacy instruments. Conclusions The PROMIS pediatric measures are feasible to use for boys with hemophilia. With the use of the PROMIS measures in clinical care and research, a step toward worldwide standardization of PROM administration can be taken.
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Affiliation(s)
- Lorynn Teela
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental health and Digital health, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands
| | - Michiel A.J. Luijten
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental health and Methodology, Amsterdam, The Netherlands
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Isolde A.R. Kuijlaars
- Centre for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Tessa C.M. van Gastel
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental health and Health Behaviours & Chronic Diseases, Amsterdam, The Netherlands
| | - Evelien S. van Hoorn
- Department of Public Health, Erasmus MC, Erasmus University Medical Centre Rotterdam, The Netherlands
| | - Samantha C. Gouw
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Paediatric Haematology, Amsterdam, The Netherlands
| | - Karin C.J. Fijnvandraat
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Paediatric Haematology, Amsterdam, The Netherlands
| | - Kathelijn Fischer
- Centre for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marjon H. Cnossen
- Department of Paediatric Haematology, Erasmus MC Sophia Children’s Hospital, Erasmus University Medical Centre Rotterdam, The Netherlands
| | - Sasja Andeweg
- Department of Paediatric Haematology, Erasmus MC Sophia Children’s Hospital, Erasmus University Medical Centre Rotterdam, The Netherlands
| | | | - Corinne Liem
- Department of Pediatric Haemato-Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Marjolein Peters
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Paediatric Haematology, Amsterdam, The Netherlands
| | - Lotte Haverman
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental health and Digital health, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands
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Kloosterman FR, Zwagemaker AF, Bay-Jensen AC, Cnossen MH, Kruip MJHA, Leebeek FWG, Hemke R, Maas M, Fijnvandraat K, Gouw SC, Coppens M. Poor correlation between biomarkers and MRI-detected joint damage in a cross-sectional study of persons with nonsevere hemophilia A (DYNAMO study). J Thromb Haemost 2023; 21:1813-1823. [PMID: 37019364 DOI: 10.1016/j.jtha.2023.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Persons with nonsevere hemophilia A (NSHA) experience less frequent joint bleeding than persons with severe hemophilia A, but may still develop joint damage. Biomarkers of cartilage and synovial remodeling can reflect ongoing pathologic processes that may precede or coincide with damage on joint imaging. If so, biomarkers may be an important diagnostic tool for joint damage in NSHA. OBJECTIVE To assess the correlation between biomarkers and MRI-detected joint damage in persons with NSHA. METHODS In a cross-sectional study, men with NSHA (factor VIII [FVIII], 2-35 IU/dL) were included. Participants underwent magnetic resonance imaging of elbows, knees, and ankles and blood and urine sampling for biomarker analysis on a single visit. The following biomarker(s) were analyzed in urine: CTX-II or serum: cartilage oligomeric matrix protein, chondroitin sulfate 846, vascular cell adhesion molecule 1, osteopontin (OPN), neo-epitope of MMP -mediated degradation of type II collagen, N-terminal propeptide of type II collagen, collagen type IV M, and propetide of type IV collagen. Spearman's rank correlations were calculated between these biomarkers and the total International Prophylaxis Study group (IPSG) score, soft-tissue subscore, and osteochondral subscore. RESULTS In total, 48 persons with NSHA were included. Median age was 43 years (range, 24-55 years) and median FVIII was 10 IU/dL (IQR, 4-16 IU/dL). The median IPSG score was 4 (IQR, 2-9). Median IPSG soft-tissue subscores were 3 (IQR, 2-4) and osteochondral subscores were 0 (IQR, 0-4). No strong correlations were found between the studied biomarkers, total IPSG score, subsequent soft-tissue, and osteochondral subscores. CONCLUSIONS In this study, selected biomarkers indicative of different aspects of hemophilic arthropathy showed no consistent correlation with IPSG scores. This suggests that systemically measured biomarkers are currently not suitable for identifying milder joint damage in NSHA, as observed on magnetic resonance imaging.
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Affiliation(s)
- Fabienne R Kloosterman
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Amsterdam, the Netherlands
| | - Anne-Fleur Zwagemaker
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Amsterdam, the Netherlands
| | - Anne C Bay-Jensen
- Immunoscience, Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - Marjon H Cnossen
- Department of Pediatric Hematology and Oncology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Frank W G Leebeek
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Robert Hemke
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Mario Maas
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Karin Fijnvandraat
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Amsterdam, the Netherlands; Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, the Netherlands
| | - Samantha C Gouw
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Amsterdam, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Pulmonary Hypertension & Thrombosis, Amsterdam, the Netherlands.
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8
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Romano LG, van Vulpen LF, den Exter PL, Heubel-Moenen FC, Hooijmeijer HL, Coppens M, Fijnvandraat K, Schols SE, Ypma PF, Smit C, Driessens MH, Rosendaal FR, van der Bom JG, Gouw SC, Kruip MJ. Desmopressin in nonsevere hemophilia A: patient perspectives on use and efficacy. Res Pract Thromb Haemost 2023; 7:100281. [PMID: 37601028 PMCID: PMC10439392 DOI: 10.1016/j.rpth.2023.100281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/22/2023] [Accepted: 06/01/2023] [Indexed: 08/22/2023] Open
Abstract
Background Desmopressin increases plasma factor VIII and von Willebrand factor levels in persons with nonsevere hemophilia A. Patients' perspectives on desmopressin are relevant to increase and optimize its suboptimal use. However, patients' views on desmopressin are not reported. Objectives To evaluate the perspectives of persons with nonsevere hemophilia A on desmopressin use, barriers for its use, side effects, and their knowledge about desmopressin's efficacy and side effects. Methods Persons with nonsevere hemophilia A were included in a cross-sectional, national, multicenter study. Questionnaires were filled out by adult patients and children aged ≥12 years themselves. Caretakers filled out questionnaires for children aged <12 years. Results In total, 706 persons with nonsevere hemophilia A were included (544 mild, 162 moderate, [age range, 0-88 years]). Of 508 patients, 234 (50%) patients reported previous desmopressin use. Desmopressin was considered as at least moderately effective in 171 of 187 (90%) patients. Intranasal administration was the modality of choice for 138 of 182 (76%) patients. Flushing was the most reported side effect in 54 of 206 (26%) adults and 7 of 22 (32%) children. The most frequently reported advantage and disadvantage were the convenience of intranasal, out-of-hospital administration by 56% (126/227) and side effects in 18% (41/227), respectively. Patients' self-perceived knowledge was unsatisfactory or unknown in 28% (63/225). Conclusion Overall, desmopressin was most often used intranasally and considered effective, with flushing as the most common side effect. The most mentioned advantage was the convenience of intranasal administration and disadvantage was side effects. More information and education on desmopressin could answer unmet needs in patients with current or future desmopressin treatment.
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Affiliation(s)
- Lorenzo G.R. Romano
- Department of Hematology, Hemophilia Treatment Center, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Lize F.D. van Vulpen
- Center for Benign Hematology, Thrombosis and Hemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Paul L. den Exter
- Department of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Helene L. Hooijmeijer
- Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Pulmonary Hypertension & Thrombosis, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Amsterdam University Medical Center - Emma Children’s Hospital, University of Amsterdam, Amsterdam, The Netherlands
- Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
| | - Saskia E.M. Schols
- Department of Hematology, Radboud University Medical Center and Hemophilia Treatment Center, Nijmegen-Eindhoven-Maastricht, Nijmegen, The Netherlands
| | - Paula F. Ypma
- Department of Hematology, Haga Hospital, The Hague, The Netherlands
| | - Cees Smit
- Netherlands Hemophilia Patient Society (NVHP), Nijkerk, The Netherlands
| | | | - Frits R. Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Johanna G. van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Samantha C. Gouw
- Department of Pediatric Hematology, Amsterdam University Medical Center - Emma Children’s Hospital, University of Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marieke J.H.A. Kruip
- Department of Hematology, Hemophilia Treatment Center, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
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9
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Brands MR, Haverman L, Muis JJ, Driessens MH, van der Meer FJ, Goedhart G, Meijer S, de Jong M, van der Bom JG, Cnossen MH, Fijnvandraat K, Gouw SC. Patients' and health care providers' perspectives on quality of hemophilia care in the Netherlands: a questionnaire and interview study. Res Pract Thromb Haemost 2023; 7:100159. [PMID: 37346462 PMCID: PMC10279896 DOI: 10.1016/j.rpth.2023.100159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/27/2023] [Accepted: 04/02/2023] [Indexed: 06/23/2023] Open
Abstract
Background Hemophilia care has improved greatly because of advances in treatment options and comprehensive care. In-depth insight into the perspectives of persons with hemophilia and health care providers on their care may provide targets for further improvements. Objectives To assess satisfaction of the hemophilia population with their care, to explore factors determining care satisfaction, and to identify areas for potential health care improvements, including digital health tools. Methods First, to assess care satisfaction and factors determining satisfaction and health care improvements, data from a nationwide, cross-sectional questionnaire among 867 adult and pediatric Dutch persons with hemophilia A or B were analyzed. This included the Hemophilia Patient Satisfaction Scale questionnaire, Canadian Hemophilia Outcomes Kids' Life Assessment Tool satisfaction questions, a visual analog scale satisfaction score, and open questions. Second, to further explore factors determining satisfaction and health care improvements, semistructured interviews were conducted with 19 persons with hemophilia or their parents and 18 health care providers. Results High care satisfaction was found, with an overall median Hemophilia Patient Satisfaction Scale score of 12 (IQR, 6-21). Participants in the interviews reported that patient-professional interactions, availability of care, and coordination of care were major factors determining satisfaction. Suggested health care improvements included improved information provision and coordination of care, especially shared care with professionals not working within comprehensive care centers. Participants suggested that digital health tools could aid in this. Conclusion Satisfaction with hemophilia care is high among persons with hemophilia in the Netherlands, although several potential improvements have been identified. Accentuating these is especially relevant in the current era of treatment innovations, in which we might focus less on other aspects of care.
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Affiliation(s)
- Martijn R. Brands
- Department of Pediatric Hematology, Emma Children’s Hospital, Amsterdam University Medical Centers location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam, the Netherlands
| | - Lotte Haverman
- Amsterdam Reproduction & Development, Public Health, Amsterdam, the Netherlands
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Emma Children’s Hospital, Amsterdam University Medical Centers location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Jelmer J. Muis
- Amsterdam Reproduction & Development, Public Health, Amsterdam, the Netherlands
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Emma Children’s Hospital, Amsterdam University Medical Centers location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | | | - Felix J.M. van der Meer
- HemoNED Foundation, Leiden, the Netherlands
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
| | - Geertje Goedhart
- HemoNED Foundation, Leiden, the Netherlands
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
| | - Stephan Meijer
- Netherlands Hemophilia Patient Society, Nijkerk, the Netherlands
| | | | - Johanna G. van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Marjon H. Cnossen
- Department of Pediatric Hematology, Sophia Children’s Hospital, Erasmus University Medical Center, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Emma Children’s Hospital, Amsterdam University Medical Centers location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam, the Netherlands
- Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, the Netherlands
| | - Samantha C. Gouw
- Department of Pediatric Hematology, Emma Children’s Hospital, Amsterdam University Medical Centers location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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10
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Kahn SR, Arnold DM, Casari C, Desch KC, Devreese KMJ, Favaloro EJ, Gaertner F, Gouw SC, Gresele P, Griffioen AW, Heger L, Kini RM, Kohli S, Leader A, Lisman T, Lordkipanidzé M, Mullins E, Okoye HC, Rosovsky RP, Salles-Crawley II, Selby R, Sholzberg M, Stegner D, Violi F, Weyand AC, Williams S, Zheng Z. Illustrated State-of-the-Art Capsules of the ISTH 2023 Congress. Res Pract Thromb Haemost 2023; 7:100193. [PMID: 37538494 PMCID: PMC10394567 DOI: 10.1016/j.rpth.2023.100193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
This year's Congress of the International Society of Thrombosis and Haemostasis (ISTH) took place in person in Montréal, Canada, from June 24-28, 2023. The conference, held annually, highlighted cutting-edge advances in basic, translational, population and clinical sciences relevant to the Society. As for all ISTH congresses, we offered a special, congress-specific scientific theme; this year, the special theme was immunothrombosis. Certainly, over the last few years, COVID-19 infection and its related thrombotic and other complications have renewed interest in the concepts of thromboinflammation and immunothrombosis; namely, the relationship between inflammation, infection and clotting. Other main scientific themes of the Congress included Arterial Thromboembolism, Coagulation and Natural Anticoagulants, Diagnostics and Omics, Fibrinolysis and Proteolysis, Hemophilia and Rare Bleeding Disorders, Hemostatic System in Cancer, Inflammation and Immunity, Pediatrics, Platelet Disorders, von Willebrand Disease and Thrombotic Microangiopathies, Platelets and Megakaryocytes, Vascular Biology, Venous Thromboembolism and Women's Health. Among other sessions, the program included 28 State-of-the-Art (SOA) sessions with a total of 84 talks given by internationally recognized leaders in the field. SOA speakers were invited to prepare brief illustrated reviews of their talks that were peer reviewed and are included in this article. These illustrated capsules highlight the major scientific advances with potential to impact clinical practice. Readers are invited to take advantage of the excellent educational resource provided by these illustrated capsules. They are also encouraged to use the image in social media to draw attention to the high quality and impact of the science presented at the Congress.
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Affiliation(s)
- Susan R Kahn
- Medicine, Sir Mortimer B Davis Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, Montreal, Quebec
| | - Donald M Arnold
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Caterina Casari
- Université Paris-Saclay, INSERM, Hémostase inflammation thrombose HITH U1176, 94276, Le Kremlin-Bicêtre, France
| | - Karl C Desch
- Cell and Molecular Biology Program, University of Michigan, Ann Arbor, USA
| | - Katrien M J Devreese
- Coagulation Laboratory, Department of Laboratory Medicine, Ghent University Hospital, Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Emmanuel J Favaloro
- Haematology, Sydney Centres for Thrombosis and Haemostasis, Institute of Clinical Pathology and Medical Research (ICPMR), NSW Health Pathology, Westmead Hospital, Westmead, NSW Australia
| | - Florian Gaertner
- Technische Universität München (TUM), Ismaninger Straße 22, München, Bayern 81675, Germany
| | - Samantha C Gouw
- Amsterdam UMC location University of Amsterdam, Department of Pediatric Hematology, Meibergdreef 9, Amsterdam, The Netherlands
| | - Paolo Gresele
- University of Perugia, Department of Medicine and Surgery, Head Section of Internal and Cardiovascular Medicine
| | - Arjan W Griffioen
- Angiogenesis Laboratory, Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Lukas Heger
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA; Program in Cellular and Molecular Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Departement of Cardiology and Angiology, University Hospital Freiburg Bad Krozingen, 79106 Freiburg, Germany
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, Boston, MA 02115, USA
- Departement of Cardiology and Angiology, University Hospital Freiburg Bad Krozingen, 79106 Freiburg, Germany
| | | | - Shrey Kohli
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Universitätsklinikum Leipzig, Leipzig University, 04103 Leipzig, Germany
| | - Avi Leader
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ton Lisman
- Surgical Research Laboratory and Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Eric Mullins
- Division of Hematology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati - College of Medicine, Cincinnati, OH, USA
| | - Helen Chioma Okoye
- College of Medicine, University of Nigeria, Ituku Ozalla campus, Enugu Nigeria
| | | | | | - Rita Selby
- Departments of Laboratory Medicine & Pathobiology and Department of Medicine, University of Toronto
| | | | | | - Francesco Violi
- Department of Clinical, Internal Medicine, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Angela C Weyand
- Department of Pediatrics, University of Michigan Medical School
| | | | - Ze Zheng
- Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA
- Versiti Blood Research Institute, Milwaukee, Wisconsin 53226, USA
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11
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Brands MR, Gouw SC, Driessens MHE. [Personal health records: a promising tool?]. Ned Tijdschr Geneeskd 2023; 167. [PMID: 36928474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Currently, nearly all health care institutions in the Netherlands employ patient portals to help engage and empower patients. Yet, the fragmented landscape of incompatible portals hampers patient engagement. The implementation of national personal health records (PHRs) could help to resolve this. PHRs are websites or apps in which all relevant medical data of all health care providers involved are collected. PHRs are managed by patients. The Netherlands has adopted a free-market model, in which private companies develop PHRs and the government acts as a controlling body. Although PHRs can ultimately aid shared-decision making and patient participation, several challenges have to be overcome. How are safety and privacy taken into consideration? How will PHRs change the communication between patients and health care providers? Can we standardize and integrate all relevant patient information? And finally, how can we make PHRs understandable and easy-to-use for all patients, especially those with lower health literacy?
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Affiliation(s)
- Martijn R Brands
- Amsterdam UMC, locatie AMC, Emma Kinderziekenhuis, afd. Kinderhematologie
- Contact: Martijn R. Brands
| | - Samantha C Gouw
- Amsterdam UMC, locatie AMC, Emma Kinderziekenhuis, afd. Kinderhematologie
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12
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Verhagen MJ, van Heerde WL, van der Bom JG, Beckers EA, Blijlevens NM, Coppens M, Gouw SC, Jansen JH, Leebeek FW, van Vulpen LF, Meijer D, Schols SE. In patients with hemophilia, a decreased thrombin generation profile is associated with a severe bleeding phenotype. Res Pract Thromb Haemost 2023; 7:100062. [PMID: 36865907 PMCID: PMC9971314 DOI: 10.1016/j.rpth.2023.100062] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/20/2022] [Accepted: 01/02/2023] [Indexed: 02/04/2023] Open
Abstract
Background Heterogeneity in clinical bleeding phenotype has been observed in hemophilia patients with similar FVIII or FIX activity levels. Thrombin generation and plasmin generation, as a global hemostasis assay, may contribute to a better prediction of which patients are at an increased risk of bleeding. Objectives The objective of this study was to describe the association between clinical bleeding phenotype and thrombin generation and plasmin generation profiles in patients with hemophilia. Methods The Nijmegen Hemostasis Assay, which simultaneously measures thrombin and plasmin generation, was performed in plasma samples of patients with hemophilia participating in the sixth Hemophilia in the Netherlands study (HiN6). Patients receiving prophylaxis underwent a washout period. A severe clinical bleeding phenotype was defined as a self-reported annual bleeding rate of ≥5, a self-reported annual joint bleeding rate of ≥3, or the use of secondary/tertiary prophylaxis. Results In total, 446 patients, with a median age of 44 years, were included in this substudy. Thrombin generation and plasmin generation parameters differed between patients with hemophilia and healthy individuals. The median thrombin peak height was 1.0 nM, 25.9 nM, 47.1 nM, and 143.9 nM in patients with severe, moderate, and mild hemophilia and healthy individuals, respectively. A severe bleeding phenotype was observed in patients with a thrombin peak height of <49% and a thrombin potential of <72% compared to healthy individuals, and was independent of the hemophilia severity. The median thrombin peak height was 0.70% in patients with a severe clinical bleeding phenotype and 30.3% in patients with a mild clinical bleeding phenotype. The median thrombin potentials for these patients were 0.06% and 59.3%, respectively. Conclusion A decreased thrombin generation profile is associated with a severe clinical bleeding phenotype in patients with hemophilia. Thrombin generation in combination with bleeding severity may be a better tool to personalize prophylactic replacement therapy irrespective of hemophilia severity.
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Affiliation(s)
- Marieke J.A. Verhagen
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands,Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, The Netherlands,Department of Laboratory Medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Waander L. van Heerde
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands,Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, The Netherlands,Enzyre BV, Novio Tech Campus, Nijmegen, The Netherlands
| | - Johanna G. van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik A.M. Beckers
- Department of Hematology, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Michiel Coppens
- Department of Vascular Medicine and Haemophilia Treatment Center, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Samantha C. Gouw
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands,Pediatric Hematology, Emma Children’s Hospital, Amsterdam University Medical Center, University of Amsterdam, The Netherlands
| | - Joop H. Jansen
- Department of Laboratory Medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frank W.G. Leebeek
- Department of Hematology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lize F.D. van Vulpen
- Center for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Daniëlle Meijer
- Department of Laboratory Medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Saskia E.M. Schols
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands,Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, The Netherlands,Correspondence Saskia E. M. Schols, Department of Hematology, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands. @radboudumc_weet
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13
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Oomen I, Camelo RM, Rezende SM, Voorberg J, Mancuso ME, Oldenburg J, Carcao M, Matino D, Lillicrap D, Fischer K, Fijnvandraat K, Gouw SC. Determinants of successful immune tolerance induction in hemophilia A: systematic review and meta-analysis. Res Pract Thromb Haemost 2023; 7:100020. [PMID: 36891524 PMCID: PMC9986104 DOI: 10.1016/j.rpth.2022.100020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/31/2022] [Accepted: 11/09/2022] [Indexed: 01/21/2023] Open
Abstract
Background Immune tolerance induction (ITI) aims to eradicate anti-factor VIII (FVIII) antibodies (inhibitors) in persons with hemophilia A. However, this burdensome treatment fails in 10% to 40%. To estimate the chance of ITI success in clinical decision making, it is important to identify the predictors of ITI success. Objectives We performed a systematic review and meta-analysis to summarize the current evidence on determinants of ITI outcome in persons with hemophilia A. Methods A literature search was conducted to identify randomized controlled trials, cohort, or case-control studies reporting on the predictors for ITI outcome in persons with hemophilia A. The main outcome was ITI success. Methodological quality was assessed using an adapted Joanna Briggs Institute checklist, rating as high if ≥11 of 13 criteria were met. Pooled odds ratios (ORs) for ITI success were calculated for each determinant. ITI success was defined as negative inhibitor titer (<0.6 BU/mL), FVIII recovery ≥66% of expected, and FVIII half-life ≥6 hours in 16 (59.3%) studies. Results We included 27 studies, involving 1,734 participants. Methodological quality of 6 (22.2%) studies (418 participants) was rated as high. Twenty different determinants were assessed. Historical peak titer ≤100 BU/mL (compared with >100 BU/mL, OR, 1.7; 95% CI, 1.4-2.1), pre-ITI titer ≤10 BU/mL (compared with >10 BU/mL, OR, 1.8; 95% CI, 1.4-2.3), and peak titer during ITI ≤100 BU/mL (compared with >100 BU/mL, OR, 2.7; 95% CI, 1.9-3.8) were associated with a higher chance of ITI success. Conclusion Our results suggest that determinants related to the inhibitor titer are associated with ITI success.
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Affiliation(s)
- Ilja Oomen
- Amsterdam University Medical Center location University of Amsterdam, Department of Pediatric Hematology, Meibergdreef 9, Amsterdam, The Netherlands.,Department of Molecular Hematology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
| | - Ricardo M Camelo
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Suely Meireles Rezende
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jan Voorberg
- Department of Molecular Hematology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
| | - Maria Elisa Mancuso
- Center for Thrombosis and Hemorrhagic Diseases, Instituto di Ricovero e Cura a Carattere Scientifico Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Johannes Oldenburg
- Department of Internal Medicine, University Clinic Bonn, University of Bonn, Bonn, Germany
| | - Manuel Carcao
- Division of Hematology/Oncology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Davide Matino
- Department of Medicine, McMaster University, University of Hamilton, Hamilton, Canada
| | - David Lillicrap
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Canada
| | - Kathelijn Fischer
- Department of Hematology, Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Karin Fijnvandraat
- Amsterdam University Medical Center location University of Amsterdam, Department of Pediatric Hematology, Meibergdreef 9, Amsterdam, The Netherlands.,Department of Molecular Hematology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
| | - Samantha C Gouw
- Amsterdam University Medical Center location University of Amsterdam, Department of Pediatric Hematology, Meibergdreef 9, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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14
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van Hoorn ES, Teela L, Kuijlaars IAR, Fischer K, Gouw SC, Cnossen MH, Haverman L. Harmonizing patient-reported outcome measurements in inherited bleeding disorders with PROMIS. Haemophilia 2023; 29:357-361. [PMID: 36395776 DOI: 10.1111/hae.14694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/18/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Evelien S van Hoorn
- Erasmus MC, Erasmus University Medical Centre Rotterdam, Department of Public Health, Rotterdam, The Netherlands
| | - Lorynn Teela
- Amsterdam University Medical Centres, University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Isolde A R Kuijlaars
- Centre for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kathelijn Fischer
- Centre for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Samantha C Gouw
- Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Paediatric Haematology, Amsterdam, The Netherlands
| | - Marjon H Cnossen
- Erasmus MC Sophia Children's Hospital, Erasmus University Medical Centre Rotterdam, Department of Paediatric Haematology, The Netherlands
| | - Lotte Haverman
- Amsterdam University Medical Centres, University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
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15
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Zwagemaker AF, Kloosterman FR, Gouw SC, Boyce S, Brons P, Cnossen MH, Collins PW, Eikenboom J, Hay C, Hengeveld RCC, Jackson S, Klopper-Tol CAM, Kruip MJHA, Gorkom BLV, Male C, Nieuwenhuizen L, Shapiro S, Fijnvandraat K, Coppens M. Little discrepancy between one-stage and chromogenic factor VIII (FVIII)/IX assays in a large international cohort of persons with nonsevere hemophilia A and B. J Thromb Haemost 2022; 21:850-861. [PMID: 36696222 DOI: 10.1016/j.jtha.2022.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/03/2022] [Accepted: 11/28/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Accurate measurements of coagulation factor activity form an essential part of hemophilia management and are performed by the one-stage or chromogenic assay. Current literature suggests that approximately one-third of persons with nonsevere hemophilia A exhibit assay discrepancy, albeit with a high variability between studies. Such data are scarce in nonsevere hemophilia B. OBJECTIVES To investigate the extent of factor VIII/IX one-stage and chromogenic assay discrepancy in moderate and mild hemophilia A and B. METHODS Persons with previously diagnosed nonsevere hemophilia A and B with a factor level of 2 to 35 IU/dL were included from the international DYNAMO cohort study. Central measurements of the factor VIII and IX activity levels were performed by the one-stage and chromogenic assay. Relative and absolute discrepancy definitions were used, with the International Society on Thrombosis and Haemostasis-Scientific and Standardization Committee proposed ratio of >2.0 or <0.5 being the primary outcome. Discrepancy was also evaluated in a subgroup of 13 persons with mutations previously associated with discrepancy (≥3 cases reported in literature). RESULTS A total of 220 persons were included, of whom 3 (1%) showed assay discrepancy: 2/175 hemophilia A and 1/45 hemophilia B. Six persons (3%) exhibited an absolute difference >10 IU/dL between the assay results. In addition, with more lenient definitions, over 90% of participants (n = 197) had no discrepant results. Only 1 out of 13 persons with a mutation previously associated with discrepancy had significant assay discrepancy. CONCLUSION Little assay discrepancy was observed despite the presence of mutations previously associated with discrepancy, suggesting that the presence and magnitude of assay discrepancy are largely determined by laboratory variables.
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Affiliation(s)
- Anne-Fleur Zwagemaker
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Meibergdreef, Amsterdam, The Netherlands
| | - Fabienne R Kloosterman
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Meibergdreef, Amsterdam, The Netherlands
| | - Samantha C Gouw
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Meibergdreef, Amsterdam, The Netherlands
| | - Sara Boyce
- Department of Haematology, University Hospital Southampton, Southampton, United Kingdom
| | - Paul Brons
- Department of Pediatric Hemato-Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjon H Cnossen
- Department of Pediatric Hematology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Peter W Collins
- Cardiff Haemophilia Centre, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Jeroen Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Charles Hay
- Manchester University Department of Haematology, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Rutger C C Hengeveld
- Amsterdam UMC, University of Amsterdam, Clinical Chemistry, Meibergdreef, Amsterdam, The Netherlands
| | - Shannon Jackson
- Adult Bleeding Disorders Program of BC - Adult Division St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Caroline A M Klopper-Tol
- Amsterdam UMC, University of Amsterdam, Clinical Chemistry, Meibergdreef, Amsterdam, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Christoph Male
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | | | - Susan Shapiro
- Department of Haematology, Oxford University Hospitals NHS Foundation, Oxford NIHR Biomedical Research Centre, Oxford, United Kingdom; Radcliffe Department of Medicine, Oxford University, Oxford, United Kingdom
| | - Karin Fijnvandraat
- Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Meibergdreef, Amsterdam, The Netherlands; Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
| | - Michiel Coppens
- Amsterdam UMC, University of Amsterdam, Vascular Medicine, Meibergdreef, Amsterdam, The Netherlands; Amsterdam Cardiovascular Sciences, Pulmonary Hypertension & Thrombosis, Amsterdam, The Netherlands.
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16
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Kempers EK, van Kwawegen CB, de Meris J, Spaander MCW, Schols SEM, Ypma PF, Heubel-Moenen FCJI, van Vulpen LFD, Coppens M, van der Bom JG, Fijnvandraat K, Meijer K, Eikenboom J, Gouw SC, Leebeek FWG, Kruip MJHA. Colorectal cancer screening in patients with inherited bleeding disorders: high cancer detection rate in hemophilia patients. J Thromb Haemost 2022; 21:1177-1188. [PMID: 36696188 DOI: 10.1016/j.jtha.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/01/2022] [Accepted: 12/03/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND The population-based colorectal cancer (CRC) screening program in individuals aged 55 to 75 years in the Netherlands uses fecal immunochemical testing (FIT), to detect hemoglobin in feces, followed by colonoscopy in individuals with a positive FIT. OBJECTIVES The objectives of this study are to assess the false-positive rate, detection rate, and positive predictive value of FIT for CRC and advanced adenoma (AA) in patients with Von Willebrand disease (VWD) or hemophilia. METHODS We performed a multicenter, nationwide cross-sectional study embedded in 2 nationwide studies on VWD and hemophilia in the Netherlands. RESULTS In total, 493 patients with hemophilia (n = 329) or VWD (n = 164) were included, of whom 351 patients participated in the CRC screening program (71.2%). FIT positivity and false-positive rate in patients with hemophilia and VWD were significantly higher than those in the general population (14.8% vs. 4.3%, p < .001 and 10.3% vs. 2.3%, p <.001, respectively). In patients with hemophilia, the detection rate of CRC/AA was significantly higher than that in the general male population (4.5% vs. 1.8%, p = .02), and the positive predictive value of FIT for CRC/AA was comparable (32.3% vs. 39.7%, n.s.). In patients with VWD, the detection rate was similar to that of the general population (0.8% vs. 1.4%, n.s.), whereas the positive predictive value was significantly lower than that in the general population (6.3% vs. 36.8%, p = .02). CONCLUSION This study indicates that despite a high false-positive rate of FIT in patients with inherited bleeding disorders, the detection rate of CRC and/or AA in hemophilia patients is high. FIT performs different in patients with hemophilia or VWD compared with the general population.
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Affiliation(s)
- Eva K Kempers
- Department of Hematology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Calvin B van Kwawegen
- Department of Hematology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Joke de Meris
- Netherlands Hemophilia Society, Leiden, The Netherlands
| | - Manon C W Spaander
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Saskia E M Schols
- Department of Hematology, Radboud University Medical Center, Nijmegen and Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, The Netherlands
| | - Paula F Ypma
- Department of Hematology, Haga Hospital, The Hague, The Netherlands
| | | | - Lize F D van Vulpen
- Benign Hematology Center, Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Michiel Coppens
- Amsterdam UMC Location University of Amsterdam, Vascular Medicine, Amsterdam, The Netherlands; Amsterdam Cardiovascular Sciences, Pulmonary Hypertension & Thrombosis, Amsterdam, The Netherlands
| | - Johanna G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Karin Fijnvandraat
- Amsterdam UMC Location University of Amsterdam, Department of Pediatric Hematology, Amsterdam, The Netherlands; Sanquin Research, Department of Molecular Hematology, Amsterdam, The Netherlands; Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Karina Meijer
- Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands
| | - Jeroen Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Samantha C Gouw
- Amsterdam UMC Location University of Amsterdam, Department of Pediatric Hematology, Amsterdam, The Netherlands
| | - Frank W G Leebeek
- Department of Hematology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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17
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Mavragani A, Gouw SC, Beestrum M, Cronin RM, Fijnvandraat K, Badawy SM. Patient-Centered Digital Health Records and Their Effects on Health Outcomes: Systematic Review. J Med Internet Res 2022; 24:e43086. [PMID: 36548034 PMCID: PMC9816956 DOI: 10.2196/43086] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND eHealth tools such as patient portals and personal health records, also known as patient-centered digital health records, can engage and empower individuals with chronic health conditions. Patients who are highly engaged in their care have improved disease knowledge, self-management skills, and clinical outcomes. OBJECTIVE We aimed to systematically review the effects of patient-centered digital health records on clinical and patient-reported outcomes, health care utilization, and satisfaction among patients with chronic conditions and to assess the feasibility and acceptability of their use. METHODS We searched MEDLINE, Cochrane, CINAHL, Embase, and PsycINFO databases between January 2000 and December 2021. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Eligible studies were those evaluating digital health records intended for nonhospitalized adult or pediatric patients with a chronic condition. Patients with a high disease burden were a subgroup of interest. Primary outcomes included clinical and patient-reported health outcomes and health care utilization. Secondary outcomes included satisfaction, feasibility, and acceptability. Joanna Briggs Institute critical appraisal tools were used for quality assessment. Two reviewers screened titles, abstracts, and full texts. Associations between health record use and outcomes were categorized as beneficial, neutral or clinically nonrelevant, or undesired. RESULTS Of the 7716 unique publications examined, 81 (1%) met the eligibility criteria, with a total of 1,639,556 participants across all studies. The most commonly studied diseases included diabetes mellitus (37/81, 46%), cardiopulmonary conditions (21/81, 26%), and hematology-oncology conditions (14/81, 17%). One-third (24/81, 30%) of the studies were randomized controlled trials. Of the 81 studies that met the eligibility criteria, 16 (20%) were of high methodological quality. Reported outcomes varied across studies. The benefits of patient-centered digital health records were most frequently reported in the category health care utilization on the "use of recommended care services" (10/13, 77%), on the patient-reported outcomes "disease knowledge" (7/10, 70%), "patient engagement" (13/28, 56%), "treatment adherence" (10/18, 56%), and "self-management and self-efficacy" (10/19, 53%), and on the clinical outcome "laboratory parameters," including HbA1c and low-density lipoprotein (LDL; 16/33, 48%). Beneficial effects on "health-related quality of life" were seen in only 27% (4/15) of studies. Patient satisfaction (28/30, 93%), feasibility (15/19, 97%), and acceptability (23/26, 88%) were positively evaluated. More beneficial effects were reported for digital health records that predominantly focus on active features. Beneficial effects were less frequently observed among patients with a high disease burden and among high-quality studies. No unfavorable effects were observed. CONCLUSIONS The use of patient-centered digital health records in nonhospitalized individuals with chronic health conditions is potentially associated with considerable beneficial effects on health care utilization, treatment adherence, and self-management or self-efficacy. However, for firm conclusions, more studies of high methodological quality are required. TRIAL REGISTRATION PROSPERO (International Prospective Register of Systematic Reviews) CRD42020213285; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=213285.
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Affiliation(s)
| | - Samantha C Gouw
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
| | - Molly Beestrum
- Galter Health Sciences Library at Northwestern University, Chicago, IL, United States
| | - Robert M Cronin
- Department of Medicine, The Ohio State University, Columbus, OH, United States
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands.,Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, Netherlands
| | - Sherif M Badawy
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Division of Hematology, Oncology, and Stem Cell Transplant, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
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18
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Vanholder IM, Ecury-Goossen GM, Admiraal J, Porcelijn L, van Spaendonk RM, Gouw SC. Congenital amegakaryocytic thrombocytopenia presenting with a new thrombopoietin receptor (MPL) pathogenic variant: An instructive neonatal case. J Paediatr Child Health 2022; 58:2319-2321. [PMID: 35972311 DOI: 10.1111/jpc.16168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/08/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Inez M Vanholder
- Department of Neonatology and Paediatrics, Curaçao Medical Center, J.H.J. Hamelweg, Willemstad, Curaçao.,Department of Paediatrics, University of Antwerp, Edegem, Belgium
| | - Ginette M Ecury-Goossen
- Department of Neonatology and Paediatrics, Curaçao Medical Center, J.H.J. Hamelweg, Willemstad, Curaçao
| | - Jop Admiraal
- Department of Neonatology and Paediatrics, Curaçao Medical Center, J.H.J. Hamelweg, Willemstad, Curaçao.,Department of Paediatrics, University of Amsterdam, Amsterdam, The Netherlands
| | - Leendert Porcelijn
- Immunohematology Diagnostic Services, Sanquin Diagnostic Services, Amsterdam, The Netherlands
| | | | - Samantha C Gouw
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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19
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Kuijlaars IAR, van der Net J, van Vulpen LFD, Driessens MHE, Schols SEM, Tan M, Gouw SC, Fischer K. Validation of the pedHAL short and HAL short in Dutch children and adults with haemophilia. Haemophilia 2022; 28:1007-1015. [PMID: 35905309 PMCID: PMC9796045 DOI: 10.1111/hae.14628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The Haemophilia Activities List (HAL) and paediatric HAL assess self-reported limitations in various daily activities. To reduce patient burden, shorter versions of the pedHAL (22 items) and HAL (18 items) have been developed. AIM This study aimed to determine the agreement between the pedHAL/HALfull and pedHAL/HALshort and construct validity and internal consistency of the pedHAL/ HALshort in persons with haemophilia (PWH). METHODS A cross-sectional secondary analysis of the Hemophilia in the Netherlands-6 national survey was performed. Adult and paediatric PWH completed the original pedHAL/HALfull , from which pedHAL/ HALshort were derived. Score differences between the original and short versions were calculated. Construct validity was studied by testing hypotheses regarding the relationship of the pedHAL/HALshort with the pedHAL/HALfull , Haemophilia & Exercise Project Test-Questionnaire (HEP-Test-Q), Canadian Haemophilia Outcomes-Kids' Life Assessment Tool (CHO-KLAT) and RAND 36-item Health Survey (RAND-36) (convergent/discriminant validity) as well as its ability to discriminate between subgroups (known-group validity). Internal consistency was assessed with Cronbach's α. RESULTS We included 113 children (median 10y [range 4-17], 53% severe haemophilia) and 691 adults (median 51y [range 18-88], 35% severe). Scores of the pedHAL/HALfull and pedHAL/HALshort were similar with high correlations (>0.9). Construct validity was confirmed for the pedHAL/HALshort . The HALshort was able to discriminate between different disease severities and ages. Cronbach's α of the pedHAL/HALshort was 0.95-0.97. CONCLUSION This study confirmed the agreement between the pedHAL/HALfull and the pedHAL/HALshort and the construct validity of the pedHAL/HALshort . The next step is to study construct validity of the pedHAL/HALshort when administered as short forms.
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Affiliation(s)
- Isolde A. R. Kuijlaars
- Center for Benign HaematologyThrombosis and HaemostasisVan CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | - Janjaap van der Net
- Center for Child DevelopmentExercise and Physical LiteracyUniversity Medical Center UtrechtUtrecht UniversityUniversity Children's HospitalUtrechtthe Netherlands
| | - Lize F. D. van Vulpen
- Center for Benign HaematologyThrombosis and HaemostasisVan CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | | | - Saskia E. M. Schols
- Department of HaematologyRadboud University Medical CenterNijmegenthe Netherlands,Haemophilia Treatment Center Nijmegen‐Eindhoven‐MaastrichtRadboud University Medical CenterNijmegenthe Netherlands
| | - Melanie Tan
- Department of Vascular MedicineAmsterdam Cardiovascular SciencesAmsterdam University Medical CentersUniversity of AmsterdamAmsterdamthe Netherlands
| | - Samantha C. Gouw
- Emma Children's HospitalAmsterdam UMCUniversity of AmsterdamPediatric HematologyAmsterdamthe Netherlands,Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Kathelijn Fischer
- Center for Benign HaematologyThrombosis and HaemostasisVan CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
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20
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van Balen EC, Hassan S, Smit C, Driessens MHE, Beckers EAM, Coppens M, Eikenboom JC, Hooimeijer HL, Leebeek FWG, Mauser-Bunschoten EP, van Vulpen LFD, Schols SEM, Rosendaal FR, van der Bom JG, Gouw SC. Socioeconomic participation of persons with hemophilia: Results from the sixth hemophilia in the Netherlands study. Res Pract Thromb Haemost 2022; 6:e12741. [PMID: 36051543 PMCID: PMC9414229 DOI: 10.1002/rth2.12741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/11/2022] [Accepted: 04/22/2022] [Indexed: 11/12/2022] Open
Abstract
Background and objectives Treatment availability and comprehensive care have resulted in improved clinical outcomes for persons with hemophilia. Recent data on socioeconomic participation in the Netherlands are lacking. This study assessed participation in education, in the labor market, and social participation for persons with hemophilia compared with the general male population. Methods Dutch adults and children (5–75 years) of all hemophilia severities (n = 1009) participated in a questionnaire study that included sociodemographic, occupational, and educational variables. Clinical characteristics were extracted from electronic medical records. General population data were extracted from Statistics Netherlands. Social participation was assessed with the PROMIS Ability to Participate in Social Roles and Activities short form, with a minimal important difference set at 1.0. Results Data from 906 adults and children were analyzed. Participation in education of 20 to 24 year olds was 68% (general male population: 53%). Educational attainment was higher compared with Dutch males, especially for severe hemophilia. Absenteeism from school was more common than in the general population. The employment‐to‐population ratio and occupational disability were worse for severe hemophilia than in the general population (64.3% vs. 73.2% and 14.7% vs. 4.8%, respectively), but similar for nonsevere hemophilia. Unemployment was 5.4% (general male population: 3.4%). Absenteeism from work was less common (38% vs. 45.2%). Mean PROMIS score was similar to or higher than in the general population (54.2; SD 8.9 vs. 50; SD 10). Conclusion Socioeconomic participation of persons with nonsevere hemophilia was similar to the general male population. Some participation outcomes for persons with severe hemophilia were reduced.
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Affiliation(s)
- Erna C van Balen
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands
| | - Shermarke Hassan
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands
| | - Cees Smit
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands
| | | | - Erik A M Beckers
- Department of Hematology Maastricht University Medical Centre Maastricht The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine Amsterdam Cardiovascular Sciences Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
| | - Jeroen C Eikenboom
- Department of Internal Medicine Division of Thrombosis and Hemostasis Leiden University Medical Center Leiden The Netherlands
| | - Hélène L Hooimeijer
- Department of Paediatrics University Medical Center Groningen Groningen The Netherlands
| | - Frank W G Leebeek
- Department of Hematology Erasmus University Medical Center Erasmus MC Rotterdam The Netherlands
| | - Evelien P Mauser-Bunschoten
- Center for Benign Haematology Thrombosis and Haemostasis Van Creveldkliniek University Medical Center Utrecht University Utrecht Utrecht The Netherlands
| | - Lize F D van Vulpen
- Center for Benign Haematology Thrombosis and Haemostasis Van Creveldkliniek University Medical Center Utrecht University Utrecht Utrecht The Netherlands
| | - Saskia E M Schols
- Department of Hematology Radboud university medical center Nijmegen The Netherlands.,Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht Nijmegen The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands
| | - Johanna G van der Bom
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands.,Center for Clinical Transfusion Research Sanquin Research/LUMC Leiden The Netherlands
| | - Samantha C Gouw
- Department of Clinical Epidemiology Leiden University Medical Center The Netherlands.,Pediatric Hematology Emma Children's Hospital Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
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21
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Zwagemaker A, Kloosterman FR, Coppens M, Gouw SC, Boyce S, Bagot CN, Beckers EAM, Brons P, Castaman G, Eikenboom J, Jackson S, Kruip MJHA, Leebeek FWG, Meijer K, Nieuwenhuizen L, Pabinger I, Fijnvandraat K. Desmopressin for bleeding in non‐severe hemophilia A: Suboptimal use in a real‐world setting. Res Pract Thromb Haemost 2022; 6:e12777. [PMID: 36090159 PMCID: PMC9433315 DOI: 10.1002/rth2.12777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/28/2022] [Accepted: 06/23/2022] [Indexed: 12/03/2022] Open
Abstract
Background Desmopressin is an important treatment option in nonsevere hemophilia A because it has several benefits compared with factor (F) concentrates, including no inhibitor risk and much lower costs. Despite these advantages, data are limited on the real‐world use of desmopressin in the treatment of bleeds. Objective To describe the clinical use of desmopressin in relation to other therapeutic modalities in the treatment of bleeding episodes in patients with nonsevere hemophilia A. Methods Patients with nonsevere hemophilia A aged 12–55 years were included from the DYNAMO cohort study. Data on the desmopressin test response and treated bleeding events in the period January 2009 to July 2020 were retrospectively collected from medical files. An adequate desmopressin test response was defined based on a peak FVIII level of ≥30 IU/dl. Results A total of 248 patients with a median age of 38 years (interquartile range 25–49) were included. An adequate desmopressin test response was documented in 25% and 73% of patients with moderate and mild hemophilia, respectively. In adequate responders, 51% of bleeds were exclusively treated with FVIII concentrates, 24% exclusively with desmopressin, 21% with a combination of both and 4% with other treatments. In 54% of bleeds treated with a single dose of factor concentrates, the expected FVIII level after desmopressin exceeded the level targeted. Conclusion Most bleeds in patients with an adequate response to desmopressin are treated with factor concentrates. These findings may indicate a suboptimal use of desmopressin and that barriers to the use of desmopressin should be explored.
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Affiliation(s)
- Anne‐Fleur Zwagemaker
- Amsterdam UMC University of Amsterdam, Emma Children's Hospital, Pediatric Hematology Amsterdam The Netherlands
| | - Fabienne R. Kloosterman
- Amsterdam UMC University of Amsterdam, Emma Children's Hospital, Pediatric Hematology Amsterdam The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Samantha C. Gouw
- Amsterdam UMC University of Amsterdam, Emma Children's Hospital, Pediatric Hematology Amsterdam The Netherlands
| | - Sara Boyce
- Department of Haematology University Hospital Southampton Southampton UK
| | | | - Erik A. M. Beckers
- Department of Internal Medicine, Division of Hematology, CARIM School for Cardiovascular Diseases Maastricht University Medical Center Maastricht The Netherlands
| | - Paul Brons
- Department of Pediatric Hemato‐Oncology Radboud University Medical Center Nijmegen The Netherlands
| | - Giancarlo Castaman
- Department of Oncology, Center for Bleeding Disorders Careggi University Hospital Florence Italy
| | - Jeroen Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Hemostasis Leiden University Medical Center Leiden The Netherlands
| | - Shannon Jackson
- Adult Bleeding Disorders Program of BC ‐ Adult Division St. Paul's Hospital Vancouver British Columbia Canada
| | - Marieke J. H. A. Kruip
- Department of Hematology Erasmus MC, Erasmus University Medical Center Rotterdam The Netherlands
| | - Frank W. G. Leebeek
- Department of Hematology Erasmus MC, Erasmus University Medical Center Rotterdam The Netherlands
| | - Karina Meijer
- Department of Hematology University Medical Center Groningen, University of Groningen Groningen The Netherlands
| | | | - Ingrid Pabinger
- Clinical Division of Hematology and Hemostaseology Medical University of Vienna Vienna Austria
| | - Karin Fijnvandraat
- Amsterdam UMC University of Amsterdam, Emma Children's Hospital, Pediatric Hematology Amsterdam The Netherlands
- Department of Molecular Cellular Hemostasis Sanquin Research and Landsteiner Laboratory Amsterdam The Netherlands
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22
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Cnossen MH, van Moort I, Reitsma SH, de Maat MPM, Schutgens REG, Urbanus RT, Lingsma HF, Mathot RAA, Gouw SC, Meijer K, Bredenoord AL, van der Graaf R, Fijnvandraat K, Meijer AB, van den Akker E, Bierings R, Eikenboom JCJ, van den Biggelaar M, de Haas M, Voorberg J, Leebeek FWG. SYMPHONY consortium: Orchestrating personalized treatment for patients with bleeding disorders. J Thromb Haemost 2022; 20:S1538-7836(22)02096-7. [PMID: 35652368 PMCID: PMC9545335 DOI: 10.1111/jth.15778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/11/2022] [Accepted: 05/27/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Treatment choices for individual patients with an inborn bleeding disorder are increasingly challenging due to increasing options and rising costs for society. We have initiated an integrated interdisciplinary national research programme. OBJECTIVES The SYMPHONY consortium strives to orchestrate personalized treatment in patients with an inborn bleeding disorder, by unravelling the mechanisms behind inter-individual variations of bleeding phenotype. PATIENTS The SYMPHONY consortium will investigate patients with an inborn bleeding disorder, both diagnosed and not yet diagnosed. RESULTS Research questions are categorized under the themes: 1) Diagnosis; 2) Treatment; and 3) Fundamental research and consist of workpackages addressing specific domains. Importantly, collaborations between patients and talented researchers from different areas of expertise promise to augment the impact of the SYMPHONY consortium, leading to unique interactions and intellectual property. CONCLUSIONS SYMPHONY will perform research on all aspects of care, treatment individualization in patients with inborn bleeding disorders as well as diagnostic innovations and results of molecular genetics and cellular model technology with regard to the hemostatic process. We believe that these research investments will lead to health care innovations with long-term clinical and societal impact. This consortium has been made possible by a governmental, competitive grant from the Netherlands Organization for Scientific Research (NWO) within the framework of the NWA-ORC Call grant agreement NWA.1160.18.038.
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Affiliation(s)
- Marjon H. Cnossen
- Department of Pediatric Hematology and OncologyErasmus University Medical Center, Erasmus MC Sophia Children’s HospitalRotterdamthe Netherlands
| | - Iris van Moort
- Department of HematologyErasmus University Medical Center, Erasmus MC RotterdamRotterdamthe Netherlands
| | - Simone H. Reitsma
- Department of Pediatric Hematology and OncologyErasmus University Medical Center, Erasmus MC Sophia Children’s HospitalRotterdamthe Netherlands
| | - Moniek P. M. de Maat
- Department of HematologyErasmus University Medical Center, Erasmus MC RotterdamRotterdamthe Netherlands
| | - Roger E. G. Schutgens
- Center for Benign Hematology, Thrombosis and Hemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
| | - Rolf T. Urbanus
- Center for Benign Hematology, Thrombosis and Hemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
| | - Hester F. Lingsma
- Department of Public HealthErasmus University Medical Center, Erasmus MC RotterdamRotterdamthe Netherlands
| | - Ron A. A. Mathot
- Department of Hospital Pharmacy‐Clinical PharmacologyAmsterdam University Medical CentersAmsterdamthe Netherlands
| | - Samantha C. Gouw
- Department of Pediatric HematologyEmma Children’s Hospital, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Karina Meijer
- Department of HematologyUniversity Medical Center Groningen, University of GroningenGroningenthe Netherlands
| | | | - Rieke van der Graaf
- Julius Center for Health Sciences and Primary CareDepartment of Medical HumanitiesUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric HematologyEmma Children’s Hospital, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
- Sanquin Research, Department of Molecular HematologyAmsterdamthe Netherlands
- Landsteiner Laboratory, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Alexander B. Meijer
- Sanquin Research, Department of Molecular HematologyAmsterdamthe Netherlands
- Landsteiner Laboratory, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Emile van den Akker
- Sanquin Research, Department of HematopoiesisAmsterdamthe Netherlands
- Landsteiner Laboratory, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Ruben Bierings
- Department of HematologyErasmus University Medical Center, Erasmus MC RotterdamRotterdamthe Netherlands
| | - Jeroen C. J. Eikenboom
- Department of Internal Medicine, Division of Thrombosis and HemostasisLeiden University Medical CenterLeidenthe Netherlands
| | - Maartje van den Biggelaar
- Sanquin Research, Department of Molecular HematologyAmsterdamthe Netherlands
- Landsteiner Laboratory, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Masja de Haas
- Sanquin Diagnostic Services and Center for Clinical Transfusion ResearchAmsterdamthe Netherlands
- Department of HematologyLeiden University Medical CenterLeidenthe Netherlands
| | - Jan Voorberg
- Sanquin Research, Department of Molecular HematologyAmsterdamthe Netherlands
- Landsteiner Laboratory, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Frank W. G. Leebeek
- Department of HematologyErasmus University Medical Center, Erasmus MC RotterdamRotterdamthe Netherlands
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23
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Zwagemaker A, Kloosterman FR, Hemke R, Gouw SC, Coppens M, Romano LGR, Kruip MJHA, Cnossen MH, Leebeek FWG, Hutten BA, Maas M, Fijnvandraat K. Joint status of patients with nonsevere hemophilia A. J Thromb Haemost 2022; 20:1126-1137. [PMID: 35171522 PMCID: PMC9314729 DOI: 10.1111/jth.15676] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 10/24/2022]
Abstract
BACKGROUND Joint bleeding in hemophilia may eventually lead to joint damage. In nonsevere hemophilia, joint bleeds occur infrequently. Currently, knowledge on the joint status of patients with nonsevere hemophilia using objective imaging is limited. OBJECTIVE To investigate the joint status in patients with nonsevere hemophilia A. METHODS This cross-sectional study included patients with nonsevere hemophilia A aged 24-55 years. Joint status was assessed by magnetic resonance imaging (MRI) of the elbows, knees, and ankles and International Prophylaxis Study Group (IPSG) scores were calculated. Lifetime joint bleeding history was collected from medical files. The contribution of factors to joint outcome was explored using multivariable linear regression analysis. RESULTS In total, 51 patients were included, of whom 19 (37%) had moderate and 32 (63%) had mild hemophilia. Patients had a median age of 43 years (interquartile range [IQR] 32-50), a median factor VIII activity of 10 IU/dl (IQR 4-16) and a median annual joint bleeding rate (AJBR) of 0.0 (IQR 0.0-0.2). Soft-tissue changes (IPSG subscore > 0) in the elbows, knees, and ankles were present in 19%, 71%, and 71% of patients, respectively. Osteochondral changes (IPSG subscore > 0) in the elbows, knees, and ankles were present in 0%, 20%, and 35% of patients, respectively. In 14% of bleed-free joints, hemosiderin depositions were observed. Age and AJBRs were most strongly associated with the IPSG score. CONCLUSION This study demonstrates that a substantial proportion of adults with nonsevere hemophilia has joint changes on MRI despite low joint bleeding rates.
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Affiliation(s)
- Anne‐Fleur Zwagemaker
- Pediatric HematologyAmsterdam UMCUniversity of AmsterdamEmma Children’s HospitalAmsterdamThe Netherlands
| | - Fabienne R. Kloosterman
- Pediatric HematologyAmsterdam UMCUniversity of AmsterdamEmma Children’s HospitalAmsterdamThe Netherlands
| | - Robert Hemke
- Department of Radiology and Nuclear MedicineAmsterdam University Medical CentersUniversity of AmsterdamAmsterdam Movement SciencesAmsterdamThe Netherlands
| | - Samantha C. Gouw
- Pediatric HematologyAmsterdam UMCUniversity of AmsterdamEmma Children’s HospitalAmsterdamThe Netherlands
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Michiel Coppens
- Department of Vascular MedicineAmsterdam University Medical CentersAmsterdamthe Netherlands
| | - Lorenzo G. R. Romano
- Department of HematologyErasmus MCErasmus University Medical CenterRotterdamThe Netherlands
| | - Marieke J. H. A. Kruip
- Department of HematologyErasmus MCErasmus University Medical CenterRotterdamThe Netherlands
| | - Marjon H. Cnossen
- Department of Pediatric HematologyErasmus MC Sophia Children’s HospitalErasmus University Medical CenterRotterdamThe Netherlands
| | - Frank W. G. Leebeek
- Department of HematologyErasmus MCErasmus University Medical CenterRotterdamThe Netherlands
| | - Barbara A. Hutten
- Department of Epidemiology and Data ScienceAmsterdam Cardiovascular SciencesAmsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands
| | - Mario Maas
- Department of Radiology and Nuclear MedicineAmsterdam University Medical CentersUniversity of AmsterdamAmsterdam Movement SciencesAmsterdamThe Netherlands
| | - Karin Fijnvandraat
- Pediatric HematologyAmsterdam UMCUniversity of AmsterdamEmma Children’s HospitalAmsterdamThe Netherlands
- Department of Molecular Cellular HemostasisSanquin Research and Landsteiner LaboratoryAmsterdamThe Netherlands
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24
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Heesterbeek MR, Luijten MAJ, Gouw SC, Limperg PF, Fijnvandraat K, Coppens M, Kruip MJHA, Eikenboom J, Grootenhuis MA, Flens G, Terwee CB, Peters M, Haverman L. Measuring anxiety and depression in young adult men with haemophilia using PROMIS. Haemophilia 2022; 28:e79-e82. [PMID: 35305286 DOI: 10.1111/hae.14534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
- M R Heesterbeek
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
| | - M A J Luijten
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands.,Amsterdam UMC, Epidemiology and Data Science, Vrije Universiteit, Amsterdam, The Netherlands
| | - S C Gouw
- Emma Children's Hospital, Amsterdam UMC, Paediatric Haematology, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - P F Limperg
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
| | - K Fijnvandraat
- Emma Children's Hospital, Amsterdam UMC, Paediatric Haematology, University of Amsterdam, Amsterdam, The Netherlands
| | - M Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands
| | - M J H A Kruip
- Erasmus MC, Department of Haematology Rotterdam, Erasmus University Medical Centre, The Netherlands
| | - J Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Haemostasis, Leiden University Medical Centre, Leiden, The Netherlands
| | - M A Grootenhuis
- Princess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands
| | - G Flens
- Alliance for Quality in Mental Health Care, Utrecht, The Netherlands
| | - C B Terwee
- Emma Children's Hospital, Amsterdam UMC, Paediatric Haematology, University of Amsterdam, Amsterdam, The Netherlands
| | - M Peters
- Amsterdam UMC, Epidemiology and Data Science, Vrije Universiteit, Amsterdam, The Netherlands
| | - L Haverman
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
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25
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van Stijn D, Schoenmaker NJ, Planken RN, Koolbergen DR, Gouw SC, Kuijpers TW, Blom NA, Kuipers IM. Myocardial infarction due to thrombotic occlusion despite anticoagulation in Kawasaki disease – a case report. BMC Pediatr 2022; 22:85. [PMID: 35151308 PMCID: PMC8840548 DOI: 10.1186/s12887-022-03151-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/07/2022] [Indexed: 12/18/2022] Open
Abstract
Background Kawasaki disease (KD) is a pediatric vasculitis. Mainly the coronary arteries become affected due to acute inflammation and formation of coronary artery aneurysms (CAAs) can occur. The larger the CAA, the higher the risk for clinical complications and major adverse cardiac events, as the blood flow changes to vortex or turbulent flow facilitating thrombosis. Such patients may develop life threatening thrombotic coronary artery occlusion and myocardial ischemiaunless anti-platelet and anti-coagulation therapy is timely initiated. Case presentation We present a unique case of a 5-year-old girl with KD associated giant CAAs suffering from myocardial ischemia due to acute progressive thrombus growth despite intensive anticoagulation treatment (acetylsalicylic acid, acenocoumarol and clopidogrel) after 21 months of onset of disease. Thrombus growth continued even after percutaneous coronary intervention (PCI) with thrombolytic treatment and subsequent systemic thrombolysis, finally causing lasting myocardial damage. Acute coronary artery bypass grafting (CABG) was performed, although technically challenging at this very young age. Whereas myocardial infarction was not prevented, follow-up fortunately showed favorable recovery of heart failure. Conclusions Anticoagulation and thrombolysis may be insufficient for treatment of acute coronary syndrome in case of impending thrombotic occlusion of giant coronary aneurysms in KD. Our case demonstrates that a thrombus can still continue to grow despite triple anticoagulation therapy and well-tailored cardiovascular follow-up, which can be most likely attributed to the state of low blood flow inside the aneurysm. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03151-2.
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26
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Oomen I, Nassar-Sheikh Rashid A, Bouts AH, Gouw SC, Kuijpers TW, Rispens T, de Vries A, Wolbink G, van den Berg JM, Schonenberg-Meinema D. Anti-rituximab antibodies affect pharmacokinetics and pharmacodynamics of rituximab in children with immune-mediated diseases. Clin Exp Rheumatol 2022; 40:183-190. [DOI: 10.55563/clinexprheumatol/ftira8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Ilja Oomen
- Department of Paediatric Immunology, Rheumatology and Infectious diseases, Amsterdam University Medical Centers, Emma Children’s Hospital, Amsterdam, The Netherlands.
| | - Amara Nassar-Sheikh Rashid
- Department of Paediatric Immunology, Rheumatology and Infectious diseases, Amsterdam University Medical Centers, Emma Children’s Hospital, Amsterdam, The Netherlands
| | - Antonia H.M. Bouts
- Department of Paediatric Nephrology, Amsterdam University Medical Centers, Emma Children’s Hospital, Amsterdam, The Netherlands
| | - Samantha C. Gouw
- Department of Paediatric Haematology, Amsterdam University Medical Centers, Emma Children’s Hospital, Amsterdam, The Netherlands
| | - Taco W. Kuijpers
- Department of Paediatric Immunology, Rheumatology and Infectious diseases, Amsterdam University Medical Centers, Emma Children’s Hospital, Amsterdam, The Netherlands
| | - Theo Rispens
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
| | - Annick de Vries
- Department of Biologics Laboratory, Bioanalysis, Sanquin Diagnostic Services, Amsterdam, The Netherlands
| | - Gertjan Wolbink
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam, and Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, The Netherlands
| | - J. Merlijn van den Berg
- Department of Paediatric Immunology, Rheumatology and Infectious diseases, Amsterdam University Medical Centers, Emma Children’s Hospital, Amsterdam, The Netherlands
| | - Dieneke Schonenberg-Meinema
- Department of Paediatric Immunology, Rheumatology and Infectious diseases, Amsterdam University Medical Centers, Emma Children’s Hospital, Amsterdam, The Netherlands
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27
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van Hoorn ES, Houwing ME, Al Arashi W, Leebeek FWG, Hazelzet JA, Gouw SC, Schutgens REG, Schols SEM, Lingsma HF, Cnossen MH. Patient-reported outcomes in autosomal inherited bleeding disorders: A systematic literature review. Haemophilia 2022; 28:197-214. [PMID: 35040234 PMCID: PMC9305757 DOI: 10.1111/hae.14492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 10/31/2021] [Accepted: 12/23/2021] [Indexed: 01/04/2023]
Abstract
Aim Currently, it is unknown which patient‐reported outcomes are important for patients with autosomal inherited bleeding disorders. Therefore, the purpose of this study is to systematically review the available literature assessing patient‐reported outcomes and their measurement methods in autosomal inherited bleeding disorders. Methods The Embase, Medline ALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trails and Google Scholar databases were searched from inception until 14 August 2020. Studies on patient‐reported outcomes in patients with von Willebrand disease, inherited platelet function disorders and coagulation factor deficiencies were included. Results Twenty‐one articles met the inclusion criteria. Three studies were assessed as having poor quality, and therefore a high risk of bias. Nineteen studies had fair quality rating. Different measurements methods were used, ranging from predefined to self‐developed questionnaires. The majority of included studies focused on von Willebrand disease. Patients with von Willebrand disease reported lower health‐related quality of life compared to the general population. Overall, this trend was especially visible in the following domains: vitality, physical and social functioning and pain. Women with inherited bleeding disorders scored lower on health‐related quality of life compared to men, especially women with heavy menstrual bleeding. Patients with joint bleeds or heavy menstrual bleeding reported an increased level of pain. Conclusion Patients with autosomal inherited bleeding disorders report lower health related quality of life, especially those with joint bleeds or heavy menstrual bleeding. Numerous measurement methods are used in patients with autosomal inherited bleeding disorders, highlighting the need for studies using established, standardized measurement methods.
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Affiliation(s)
- Evelien S van Hoorn
- Erasmus MC, University Medical Centre Rotterdam, Department of Public Health, Rotterdam, The Netherlands
| | - Maite E Houwing
- Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Department of Paediatric Haematology, Rotterdam, The Netherlands
| | - Wala Al Arashi
- Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Department of Paediatric Haematology, Rotterdam, The Netherlands
| | - Frank W G Leebeek
- Erasmus MC, Erasmus University Medical Centre Rotterdam, Department of Haematology, Rotterdam, The Netherlands
| | - Jan A Hazelzet
- Erasmus MC, University Medical Centre Rotterdam, Department of Public Health, Rotterdam, The Netherlands
| | - Samantha C Gouw
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Department of Paediatric Haematology, Amsterdam, The Netherlands
| | - Roger E G Schutgens
- Van Creveldkliniek, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Saskia E M Schols
- Radboud University Medical Centre, Department of Haematology, Nijmegen, The Netherlands
| | - Hester F Lingsma
- Erasmus MC, University Medical Centre Rotterdam, Department of Public Health, Rotterdam, The Netherlands
| | - Marjon H Cnossen
- Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Department of Paediatric Haematology, Rotterdam, The Netherlands
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- Erasmus MC, University Medical Centre Rotterdam, Department of Public Health, Rotterdam, The Netherlands
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28
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Kuijlaars IAR, Teela L, van Vulpen LFD, Timmer MA, Coppens M, Gouw SC, Peters M, Kruip MJHA, Cnossen MH, Muis JJ, van Hoorn ES, Haverman L, Fischer K. Generic PROMIS item banks in adults with hemophilia for patient-reported outcome assessment: Feasibility, measurement properties, and relevance. Res Pract Thromb Haemost 2021; 5:e12621. [PMID: 34849449 PMCID: PMC8606028 DOI: 10.1002/rth2.12621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/02/2021] [Accepted: 10/13/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Legacy hemophilia-specific questionnaires are considered too long, show floor-/ceiling effects, and/or include irrelevant questions. Patient Reported Outcomes Measurement Information System (PROMIS) item banks, including Computer Adaptive Tests (CATs) and short forms, were designed for more efficient outcome assessment. OBJECTIVES Evaluate the feasibility, measurement properties, and relevance of seven PROMIS CATs and two short forms in patients with hemophilia. PATIENTS/METHODS In this cross-sectional study, Dutch adults with hemophilia completed nine PROMIS item banks electronically. Feasibility was assessed by number of items and floor/ceiling effects. Reliability was determined as the proportion of reliable scores (standard error ≤3.2). Construct validity was assessed by comparison with legacy instruments and expected differences between subgroups. Relevance of item banks was determined by proportions of limited scores. RESULTS Overall, 142 of 373 invited patients (mean age, 47 [range, 18-79], 49% severe hemophilia, 46% receiving prophylaxis) responded. Per CAT item bank, mean number of items answered varied from 5 (range, 3-12) to 9 (range, 5-12), with floor effects in pain interference (26% lowest scores) and depression (18% lowest scores). Construct validity and reliability were good for physical function, pain interference, satisfaction with social roles and activities, and fatigue. The CAT physical function showed the most limited scores (38%). The self-efficacy short forms showed ceiling effects (22%-28%) and no relation with the legacy instruments. CONCLUSIONS The PROMIS CATs physical function, pain interference, satisfaction with social roles and activities, and fatigue are feasible, reliable, and valid alternatives to legacy instruments for patients with hemophilia, with few items and low floor-/ceiling effects.
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Affiliation(s)
- Isolde A. R. Kuijlaars
- Van CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Lorynn Teela
- Amsterdam University Medical CentersEmma Children’s HospitalChild and Adolescent Psychiatry & Psychosocial CareAmsterdam Reproduction and DevelopmentAmsterdam Public HealthUniversity of AmsterdamAmsterdamThe Netherlands
| | - Lize F. D. van Vulpen
- Van CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Merel A. Timmer
- Van CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Michiel Coppens
- Department of Vascular MedicineAmsterdam Cardiovascular SciencesAmsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands
| | - Samantha C. Gouw
- Emma Children’s HospitalAmsterdam University Medical CentersPediatric HematologyUniversity of AmsterdamAmsterdamThe Netherlands
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Marjolein Peters
- Emma Children’s HospitalAmsterdam University Medical CentersPediatric HematologyUniversity of AmsterdamAmsterdamThe Netherlands
| | - Marieke J. H. A. Kruip
- Erasmus MCDepartment of HematologyErasmus University Medical Center RotterdamRotterdamThe Netherlands
| | - Marjon H. Cnossen
- Erasmus MCDepartment of Pediatric HematologySophia Children’s HospitalErasmus University Medical Center RotterdamRotterdamThe Netherlands
| | - Jelmer J. Muis
- Amsterdam University Medical CentersEmma Children’s HospitalChild and Adolescent Psychiatry & Psychosocial CareAmsterdam Reproduction and DevelopmentAmsterdam Public HealthUniversity of AmsterdamAmsterdamThe Netherlands
- Emma Children’s HospitalAmsterdam University Medical CentersPediatric HematologyUniversity of AmsterdamAmsterdamThe Netherlands
| | - Evelien S. van Hoorn
- Erasmus MCDepartment of Public HealthErasmus University Medical Center RotterdamRotterdamThe Netherlands
| | - Lotte Haverman
- Amsterdam University Medical CentersEmma Children’s HospitalChild and Adolescent Psychiatry & Psychosocial CareAmsterdam Reproduction and DevelopmentAmsterdam Public HealthUniversity of AmsterdamAmsterdamThe Netherlands
| | - Kathelijn Fischer
- Van CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
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29
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Isfordink CJ, Gouw SC, van Balen EC, Hassan S, Beckers EAM, van der Bom JG, Coppens M, Eikenboom J, Fischer K, Hooimeijer L, Leebeek FWG, Rosendaal FR, Schols SEM, Smit C, van Vulpen LFD, Mauser‐Bunschoten EP. Hepatitis C virus in hemophilia: Health-related quality of life after successful treatment in the sixth Hemophilia in the Netherlands study. Res Pract Thromb Haemost 2021; 5:e12616. [PMID: 34870068 PMCID: PMC8599142 DOI: 10.1002/rth2.12616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/28/2021] [Accepted: 10/03/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Persons with hemophilia and hepatitis C virus (HCV) infection have a lower health-related quality of life (HRQoL) than those never HCV infected. However, it is unknown whether HRQoL after HCV eradication is comparable to individuals never HCV infected. We aimed to compare HRQoL between HCV-cured and never chronically HCV-infected persons with hemophilia. METHODS All persons with hemophilia in the Netherlands were invited for a nationwide study conducted in 2018-2019. For the current analysis, participants born before 1992 with data on HRQoL and HCV status were included. HCV status was collected from medical records. HRQoL was measured by RAND-36 questionnaire, with a minimally important difference set at 4.0 points. Multivariable linear regression was used to adjust for age, hemophilia severity, HIV status, and self-reported joint impairment. RESULTS In total, 486 persons were eligible; 180 were HCV cured and 306 never chronically HCV infected. Compared with those never HCV infected, HCV-cured individuals were older (57 vs. 53 years), more often had severe hemophilia (67% vs. 21%), and reported more impaired joints (median 3 vs. 0). Compared with those never HCV infected, adjusted RAND-36 domain scores of HCV-cured individuals cured were lower on all RAND-36 domains except Pain, ranging from a difference of 4.5 (95% CI, -8.8 to -0.3) for Physical functioning to 11.3 (95% CI, -19.4 to -3.1) for Role limitations due to physical problems. CONCLUSION Despite effective HCV treatment, HRQoL of HCV-cured persons with hemophilia is still lower than HRQoL of those never chronically HCV-infected on all RAND-36 domains. This implies that careful psychosocial follow-up and support are indicated.
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Affiliation(s)
- Cas J. Isfordink
- Van CreveldkliniekCenter for Benign HaematologyUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
- Department of Gastroenterology and HepatologyUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Samantha C. Gouw
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
- Department of Pediatric HematologyAmsterdam UMCEmma Children's HospitalUniversity of AmsterdamAmsterdamThe Netherlands
| | - Erna C. van Balen
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Shermarke Hassan
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Erik A. M. Beckers
- Department of HematologyMaastricht University Medical CentreMaastrichtThe Netherlands
| | - Johanna G. van der Bom
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
- Center for Clinical Transfusion ResearchSanquin‐Leiden University Medical CenterLeidenThe Netherlands
| | - Michiel Coppens
- Department of Vascular MedicineAmsterdam Cardiovascular SciencesAmsterdam University Medical CentresUniversity of AmsterdamAmsterdamThe Netherlands
| | - Jeroen Eikenboom
- Division of Thrombosis and HemostasisDepartment of Internal MedicineLeiden University Medical CenterLeidenThe Netherlands
| | - Kathelijn Fischer
- Van CreveldkliniekCenter for Benign HaematologyUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Louise Hooimeijer
- Department of PaediatricsUniversity Medical Center GroningenGroningenThe Netherlands
| | - Frank W. G. Leebeek
- Department of HematologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Frits R. Rosendaal
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Saskia E. M. Schols
- Department of HematologyRadboud University Medical CenterNijmegenThe Netherlands
- Hemophilia Treatment Center Nijmegen‐Eindhoven‐MaastrichtNijmegenThe Netherlands
| | - Cees Smit
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Lize F. D. van Vulpen
- Van CreveldkliniekCenter for Benign HaematologyUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Eveline P. Mauser‐Bunschoten
- Van CreveldkliniekCenter for Benign HaematologyUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
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30
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van Balen EC, Haverman L, Hassan S, Taal EM, Smit C, Driessens MH, Beckers EAM, Coppens M, Eikenboom J, Hooimeijer HL, Leebeek FWG, van Vulpen LFD, Schols SEM, Terwee CB, Rosendaal FR, van der Bom JG, Gouw SC. Validation of PROMIS Profile-29 in adults with hemophilia in the Netherlands. J Thromb Haemost 2021; 19:2687-2701. [PMID: 34245088 PMCID: PMC8596807 DOI: 10.1111/jth.15454] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/19/2021] [Accepted: 07/07/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The Patient-Reported Outcomes Measurement Information System (PROMIS) Profile-29 questionnaire is widely used worldwide, but it has not yet been validated in the Netherlands, nor in persons with hemophilia. OBJECTIVE To validate the Dutch-Flemish version of the PROMIS-29 Profile v2.01 in adults with hemophilia. METHODS Dutch males with hemophilia (all severities) completed questionnaires that contained sociodemographic and clinical characteristics, the PROMIS-29, RAND-36, and the Hemophilia Activities List (HAL). Structural validity of each subscale was assessed with confirmatory factor analysis (CFA). Internal consistency was calculated for each subscale with sufficient model fit in CFA. Construct validity was assessed by testing hypotheses about (1) correlations of each PROMIS-29 subscale with corresponding scales of RAND-36 and domains of HAL, and (2) mean differences in T-scores between subgroups with different hemophilia severities, self-reported joint impairment, and HIV infection status. We considered ≥75% of data in accordance with the hypotheses evidence for construct validity. RESULTS In total, 770 persons with hemophilia participated in this cross-sectional study. CFA revealed sufficient structural validity for five subscales: Physical Function, Depression, Sleep Disturbance, Ability to Participate in Social Roles and Activities, and Pain Interference. Internal consistency was high and Cronbach's alpha ranged from 0.79 for Sleep Disturbance to 0.96 for Pain Interference. Differences between clinical subgroups were in the expected direction. Construct validity was confirmed for Physical Function, Anxiety, Depression, Fatigue, Sleep Disturbance, and Pain Intensity. CONCLUSION This study revealed sufficient evidence for structural validity, internal consistency, and construct validity for most PROMIS Profile-29 subscales among people with hemophilia in the Netherlands.
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Affiliation(s)
- Erna C. van Balen
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Lotte Haverman
- Child and Adolescent Psychiatry & Psychosocial CareAmsterdam Reproduction and DevelopmentAmsterdam Public HealthEmma Children’s HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Shermarke Hassan
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Elisabeth M. Taal
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Cees Smit
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | | | - Erik A. M. Beckers
- Department of HematologyMaastricht University Medical CentreMaastrichtThe Netherlands
| | - Michiel Coppens
- Department of Vascular MedicineAmsterdam Cardiovascular SciencesAmsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands
| | - Jeroen Eikenboom
- Department of Internal MedicineDivision of Thrombosis and HemostasisLeiden University Medical CenterLeidenThe Netherlands
| | - Hélène L. Hooimeijer
- Department of PaediatricsUniversity Medical Center GroningenGroningenThe Netherlands
| | | | - Lize F. D. van Vulpen
- Department of Benign HematologyVan CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Saskia E. M. Schols
- Department of HematologyRadboud University Medical CenterNijmegenthe Netherlands
- Hemophilia Treatment Center Nijmegen‐Eindhoven‐MaastrichtNijmegenThe Netherlands
| | - Caroline B. Terwee
- Department of Epidemiology and Data ScienceAmsterdam Public Health Research InstituteAmsterdam UMCVrije Universiteit AmsterdamThe Netherlands
| | - Frits R. Rosendaal
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Johanna G. van der Bom
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
- Center for Clinical Transfusion ResearchSanquin Research/LUMCLeidenThe Netherlands
| | - Samantha C. Gouw
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
- Department of Pediatric HematologyEmma Children’s HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
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31
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Nagelkerke SCJ, Schoenmaker MHA, Tabbers MM, Benninga MA, van Ommen CH, Gouw SC. Prophylactic anticoagulation in children receiving home parenteral nutrition. JPEN J Parenter Enteral Nutr 2021; 46:1036-1044. [PMID: 34719795 DOI: 10.1002/jpen.2298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/13/2021] [Accepted: 10/25/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Children with intestinal failure (IF) are at risk of loss of vascular access because of catheter-related venous thrombosis. Whether primary prophylactic anticoagulation is effective and safe in preventing catheter-related thrombosis is largely unknown. Our aim was to assess the incidences of catheter-related venous thrombosis and bleeding complications in children with IF receiving home parenteral nutrition (HPN) treated with primary prophylactic anticoagulation. METHODS All children, aged 0-18 years, treated with HPN at the Emma Children's Hospital/Amsterdam UMC were followed from January 2007 to July 2019. All patients were offered primary prophylactic anticoagulation from the start of HPN. The primary outcomes were catheter-related venous thrombosis and bleeding on prophylactic anticoagulation. RESULTS In total, 55 (76%) of 74 patients received primary prophylactic anticoagulation. The median age at the start of prophylaxis was 8.4 (interquartile range [IQR], 5.0-55.7) months. Patients were followed for a median of 31.2 (IQR, 10.7-53.5) months, with a total of 65,463 catheter days. The incidence of catheter-related thrombosis on prophylactic anticoagulation was 0.2 per 1000 catheter days. In total, the incidence of clinically relevant bleeding was 0.1 per 1000 catheter days. The median time to first event was 1268 (IQR, 149-2014) days for thrombosis and 389 (IQR, 227-2912) days for clinically relevant bleeding. Cumulative event-free survival after 5 years was 78% for thrombosis. CONCLUSIONS Our study shows a low rate of catheter-related venous thrombosis and a slightly elevated rate of clinically relevant bleeding in children receiving HPN and primary prophylactic anticoagulation.
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Affiliation(s)
- Sjoerd Cornelis Johannes Nagelkerke
- Pediatric Gastroenterology, Hepatology, and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Amsterdam UMC, University of Amsterdam, Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands.,Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam, the Netherlands
| | | | - Merit M Tabbers
- Pediatric Gastroenterology, Hepatology, and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Amsterdam UMC, University of Amsterdam, Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands.,Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam, the Netherlands
| | - Marc Alexander Benninga
- Pediatric Gastroenterology, Hepatology, and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Amsterdam UMC, University of Amsterdam, Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands.,Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam, the Netherlands
| | - C Heleen van Ommen
- Pediatric Hematology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Samantha C Gouw
- Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.,Amsterdam UMC, University of Amsterdam, Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
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32
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Kloosterman FR, Abdi A, Gouw SC, Hart DP, Fijnvandraat K. The factor VIII treatment history of non-severe hemophilia A-Response from original authors Abdi et al. J Thromb Haemost 2021; 19:2642-2644. [PMID: 34558782 DOI: 10.1111/jth.15474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Fabienne R Kloosterman
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Amal Abdi
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Samantha C Gouw
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Daniel P Hart
- Barts and the London School of Medicine and Dentistry, The Royal London Haemophilia Centre, QMUL, London, UK
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, the Netherlands
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33
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Hassan S, van Balen EC, Smit C, Mauser‐Bunschoten EP, van Vulpen LFD, Eikenboom J, Beckers EAM, Hooimeijer L, Ypma PF, Nieuwenhuizen L, Coppens M, Schols SEM, Leebeek FWG, Driessens MH, Rosendaal FR, van der Bom JG, Gouw SC. Health and treatment outcomes of patients with hemophilia in the Netherlands, 1972-2019. J Thromb Haemost 2021; 19:2394-2406. [PMID: 34117710 PMCID: PMC8518083 DOI: 10.1111/jth.15424] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 06/07/2021] [Indexed: 01/19/2023]
Abstract
INTRODUCTION We conducted six cross-sectional nationwide questionnaire studies among all patients with hemophilia in the Netherlands from 1972 until 2019 to assess how health outcomes have changed, with a special focus on patients >50 years of age. METHODS Data were collected on patient characteristics, treatment, (joint) bleeding, joint impairment, hospitalizations, human immunodeficiency virus and hepatitis C infections, and general health status (RAND-36). RESULTS In 2019, 1009 patients participated, of whom 48% had mild, 15% moderate, and 37% severe hemophilia. From 1972 to 2019, the use of prophylaxis among patients with severe hemophilia increased from 30% to 89%. Their median annual bleeding rate decreased from 25 to 2 bleeds. Patients with severe hemophilia aged <16 years reported joint impairment less often over time, but in those aged >40 years joint status did not improve. In 2019, 5% of all 1009 patients were positive for the human immunodeficiency virus. The proportion of patients with an active hepatitis C infection drastically decreased from 45% in 2001 to 2% in 2019 due to new anti-hepatitis C treatment options. Twenty-five percent had significant liver fibrosis even after successful therapy. Compared to the general male population, patients aged >50 years reported much lower scores on the RAND-36, especially on physical functioning. DISCUSSION/CONCLUSION Our study shows that increased use of prophylactic treatment and effective hepatitis C treatment have improved joint health and nearly eradicated hepatitis C infection in patients with hemophilia in the Netherlands. However, patients still suffer from hemophilia-related complications, especially patients aged >50 years.
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Affiliation(s)
- Shermarke Hassan
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Erna C. van Balen
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Cees Smit
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
| | | | - Lize F. D. van Vulpen
- Van CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | - Jeroen Eikenboom
- Department of Internal MedicineDivision of Thrombosis and HemostasisLeiden University Medical CenterLeidenthe Netherlands
| | - Erik A. M. Beckers
- Department of HematologyMaastricht University Medical CentreMaastrichtthe Netherlands
| | - Louise Hooimeijer
- Department of PaediatricsUniversity Medical Center GroningenGroningenthe Netherlands
| | - Paula F. Ypma
- Department of HematologyHagaZiekenhuisThe Haguethe Netherlands
| | | | - Michiel Coppens
- Department of Vascular MedicineAmsterdam University Medical CentresAmsterdamthe Netherlands
| | - Saskia E. M. Schols
- Department of HematologyRadboud University Medical CenterNijmegenthe Netherlands
- Hemophilia Treatment Center Nijmegen‐Eindhoven‐MaastrichtNijmegenthe Netherlands
| | | | | | - Frits R. Rosendaal
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Johanna G. van der Bom
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
- Center for Clinical Transfusion ResearchSanquin‐Leiden University Medical CenterLeidenthe Netherlands
| | - Samantha C. Gouw
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
- Pediatric HematologyEmma Children’s HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
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34
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Abdi A, Eckhardt CL, van Velzen AS, Vuong C, Coppens M, Castaman G, Hart DP, Hermans C, Laros‐van Gorkom B, Leebeek FWG, Mancuso ME, Mazzucconi MG, McRae S, Oldenburg J, Male C, van der Bom JG, Fijnvandraat K, Gouw SC. Treatment-related risk factors for inhibitor development in non-severe hemophilia A after 50 cumulative exposure days: A case-control study. J Thromb Haemost 2021; 19:2171-2181. [PMID: 34107158 PMCID: PMC8457239 DOI: 10.1111/jth.15419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/01/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Non-severe hemophilia A patients have a life-long inhibitor risk. Yet, no studies have analyzed risk factors for inhibitor development after 50 factor VIII (FVIII) exposure days (EDs). OBJECTIVES This case-control study investigated treatment-related risk factors for inhibitor development in non-severe hemophilia A and assessed whether these risk factors were different for early versus late inhibitor development. PATIENTS/METHODS Non-severe hemophilia A patients (FVIII:C 2%-40%) were selected from the INSIGHT study. Inhibitor-positive patients were defined as early (<50 EDs) or late (>50EDs) cases and matched to 1-4 inhibitor-negative controls by year of birth, cumulative number of EDs, and center/country. We investigated treatment intensity during the last 10 EDs prior to inhibitor development. Intensive treatment was defined as: surgery, peak treatment (10 consecutive EDs), and high mean FVIII dose (>45 IU/kg/ED). Odds ratios (OR) were calculated by logistic regression. RESULTS Of 2709 patients, we analyzed 63 early and 26 late cases and 195 and 71 respectively matched controls. Peak treatment was associated with early and late inhibitor risk (crude OR 1.8, 95% confidence interval [CI] 1.0-3.4; 4.0, 95%CI 1.1-14.3). This association was slightly less pronounced after adjustment for mean FVIII dose. High mean FVIII dose was also associated with early and late inhibitor risk (crude OR 2.8, 95%CI 1.5-5.1; 4.5, 95%CI 1.2-16.6). Surgery increased inhibitor risk for early cases. This was less pronounced for late cases. CONCLUSIONS Our findings suggest that intensive FVIII treatment remains a risk factor for inhibitor development in non-severe hemophilia A after more than 50 EDs. Therefore, persistent caution is required throughout the life-time treatment course.
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Affiliation(s)
- Amal Abdi
- Pediatric HematologyEmma Children’s HospitalAmsterdam University Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
| | - Corien L. Eckhardt
- Pediatric HematologyEmma Children’s HospitalAmsterdam University Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
| | - Alice S. van Velzen
- Pediatric HematologyEmma Children’s HospitalAmsterdam University Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
| | - Caroline Vuong
- Pediatric HematologyEmma Children’s HospitalAmsterdam University Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
| | - Michiel Coppens
- Vascular MedicineAmsterdam University Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
| | - Giancarlo Castaman
- OncologyCenter for Bleeding Disorders and CoagulationCareggi University HospitalFlorenceItaly
| | - Dan P. Hart
- Barts and The London School of Medicine and DentistryThe Royal London Hospital Haemophilia CentreQMULLondonUK
| | - Cedric Hermans
- Haemostasis and Thrombosis UnitCliniques Universitaires Saint‐LucUniversité Catholique de LouvainBrusselsBelgium
| | | | - Frank W. G. Leebeek
- HematologyErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Maria Elisa Mancuso
- Center for Thrombosis and Hemorrhagic DiseasesHumanitas Clinical and Research CenterRozzanoItaly
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center MilanFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | | | - Simon McRae
- HematologyLaunceston General HospitalLauncestonTasmaniaAustralia
| | - Johannes Oldenburg
- Institute of Experimental Haematology and Transfusion Medicine BonnUniversity Clinic BonnBonnGermany
| | | | - Johanna G. van der Bom
- Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
- Center for Clinical Transfusion ResearchSanquin ResearchLeidenThe Netherlands
| | - Karin Fijnvandraat
- Pediatric HematologyEmma Children’s HospitalAmsterdam University Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
- Molecular Cellular HemostasisSanquin Research and Landsteiner LaboratoryAmsterdamThe Netherlands
| | - Samantha C. Gouw
- Pediatric HematologyEmma Children’s HospitalAmsterdam University Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
- Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
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35
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Hoefnagels JW, Schrijvers LH, Leebeek FWG, Eikenboom J, Schols SEM, Smit C, Schutgens REG, Gouw SC, Fischer K. Adherence to prophylaxis and its association with activation of self-management and treatment satisfaction. Haemophilia 2021; 27:581-590. [PMID: 34019720 PMCID: PMC8362086 DOI: 10.1111/hae.14333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/10/2021] [Accepted: 04/27/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Prophylactic replacement therapy (prophylaxis) in patients with haemophilia (PWH) requires lifelong, frequent (self)infusions. Prophylaxis effectiveness depends on adherence, and the drivers of treatment adherence among PWH are unclear. AIM To quantify prophylaxis adherence and associations between adherence and patients' treatment attitudes and satisfaction in a large cohort of children and adults with haemophilia. METHODS In a nationwide, cross-sectional, questionnaire-based study, PWH with complete information currently using prophylaxis were selected. Validated Hemophilia Regimen Treatment Adherence Scale-Prophylaxis (VERITAS-Pro; normalised score range: 0-100, optimum 0) measured treatment adherence; the Patient Activation Measure (PAM-13; total score range 0-100, optimum 100) measured activation of self-management; Hemophilia Patient Satisfaction Scale (Hemo-Sat; range 0-100, optimum 0) measured treatment satisfaction. Groups were compared according to age (children: <12 years; adolescents: 12-18 years; adults >18 years) and adherence levels using non-parametric tests, and correlations were assessed using Spearman's rho. RESULTS Among 321 participants (median age 33 years, interquartile range [IQR]:15-54 years), adherence was high (median VERITAS-Pro total score 17, 89% adherent) but worsened with age, with median scores of 5, 14 and 20 in children, adolescents, adults, respectively (p < .001). Attitudes towards treatment (median 66 vs. 68) participants and treatment satisfaction (12 vs. 10) were similar between adherent and non-adherent patients. The VERITAS-Pro total score was moderately correlated with PAM-13 (r = .41) but not with Hemo-Sat (r = -.11). DISCUSSION Prophylaxis adherence was high (89%) but decreased significantly with age and was not correlated with treatment attitude or treatment satisfaction.
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Affiliation(s)
| | - Liesbeth Hélène Schrijvers
- Van CreveldkliniekUniversity Medical Center Utrecht, University UtrechtUtrechtthe Netherlands
- Institute of Nursing StudiesUtrecht University of applied sciencesUtrechtthe Netherlands
| | - Frank W. G. Leebeek
- Department of Paediatric HaematologyEmma Children's HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Jeroen Eikenboom
- Department of Internal MedicineDivision of Thrombosis and HemostasisLeiden University Medical CenterLeidenthe Netherlands
| | - Saskia E. M. Schols
- Department of HaematologyRadboud University Medical CenterNijmegenthe Netherlands
- Hemophilia Treatment Center NijmegenEindhoventhe Netherlands
| | - Cees Smit
- Department of Internal MedicineDivision of Thrombosis and HemostasisLeiden University Medical CenterLeidenthe Netherlands
| | - Roger E. G. Schutgens
- Van CreveldkliniekUniversity Medical Center Utrecht, University UtrechtUtrechtthe Netherlands
| | - Samantha C. Gouw
- Department of HaematologyErasmus MCUniversity Medical CenterRotterdamthe Netherlands
| | - Kathelijn Fischer
- Van CreveldkliniekUniversity Medical Center Utrecht, University UtrechtUtrechtthe Netherlands
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36
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Versloot O, van Balen EC, Hassan S, Schols SEM, Leebeek FWG, Eikenboom J, Coppens M, van Vulpen LFD, Smit C, Driessens MHE, van der Net J, Gouw SC, Fischer K. Similar sports participation as the general population in Dutch persons with haemophilia; results from a nationwide study. Haemophilia 2021; 27:876-885. [PMID: 34146370 PMCID: PMC8518501 DOI: 10.1111/hae.14366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/27/2021] [Accepted: 06/09/2021] [Indexed: 01/20/2023]
Abstract
Introduction Although sports participation is advocated in people with haemophilia (PWH), detailed data concerning sports participation in Dutch PWH is lacking. Aim to assess sports participation in Dutch PWH (6‐65 years) compared to the Dutch general population (GP). Methods Data from a nationwide, cross‐sectional study in PWH were analysed. Sports participation (type, duration, frequency) was assessed by the Modifiable Activities Questionnaire (MAQ), limitations in activities using the (Paediatric) Haemophilia Activities List ((Ped)HAL). Sports in the two highest categories according to the National Hemophilia Foundation classification were considered high‐risk sports. Groups were compared using Chi‐square testing. Results A total of 524 Adult PWH (median age: 45 (IQR: 30–55); 37% severe) and 126 paediatric PWH (median age: 11 (IQR: 8–14); 52% severe) were included. Sports participation was higher in adults (70%) than the GP (58%) and similar to the GP in children (PWH: 68%, GP: 72%). High‐risk sports participation decreased with age in PWH: from 65% (6‐12 years) to 17% (50‐65 years), which was also observed in the GP. Sports participation in children was independent of severity (non‐severe: 67% vs. severe: 65%; P = 0.97), but not in adults (non‐severe: 75%, severe: 62%; P < 0.01). Non‐severe PWH played more high‐risk sports than severe PWH: children at 65% vs. 48% (P = 0.05), adults at 25% vs. 15% (P = 0.07). Discussion These results suggest that sports participation in PWH was comparable to the GP. Sports participation was dependent of haemophilia severity in adults. Children were more involved in high‐risk sports than adults. More studies on sports‐related injury‐risk are needed for adequate counselling.
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Affiliation(s)
- Olav Versloot
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Erna C van Balen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Shermarke Hassan
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Saskia E M Schols
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.,Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, The Netherlands
| | - Frank W G Leebeek
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jeroen Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Lize F D van Vulpen
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cees Smit
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Janjaap van der Net
- Center for Child Development, Exercise and Physical Literacy, University Children's Hospital, University Medical Center, Utrecht, The Netherlands
| | - Samantha C Gouw
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Kathelijn Fischer
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
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- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
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37
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van Balen EC, O'Mahony B, Cnossen MH, Dolan G, Blanchette VS, Fischer K, Gue D, O'Hara J, Iorio A, Jackson S, Konkle BA, Nugent DJ, Coffin D, Skinner MW, Smit C, Srivastava A, van Eenennaam F, van der Bom JG, Gouw SC. Patient-relevant health outcomes for hemophilia care: Development of an international standard outcomes set. Res Pract Thromb Haemost 2021; 5:e12488. [PMID: 34027286 PMCID: PMC8117824 DOI: 10.1002/rth2.12488] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/05/2020] [Accepted: 12/29/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Patient-relevant health outcomes for persons with hemophilia should be identified and prioritized to optimize and individualize care for persons with hemophilia. Therefore, an international group of persons with hemophilia and multidisciplinary health care providers set out to identify a globally applicable standard set of health outcomes relevant to all individuals with hemophilia. METHODS A systematic literature search was performed to identify possible health outcomes and risk adjustment variables. Persons with hemophilia and multidisciplinary health care providers were involved in an iterative nominal consensus process to select the most important health outcomes and risk adjustment variables for persons with hemophilia. Recommendations were made for outcome measurement instruments. RESULTS Persons with hemophilia were defined as all men and women with an X-linked inherited bleeding disorder caused by a deficiency of coagulation factor VIII or IX with plasma activity levels <40 IU/dL. We recommend collecting the following 10 health outcomes at least annually, if applicable: (i) cure, (ii) impact of disease on life expectancy, (iii) ability to engage in normal daily activities, (iv) severe bleeding episodes, (v) number of days lost from school or work, (vi) chronic pain, (vii) disease and treatment complications, (viii) sustainability of physical functioning, (ix) social functioning, and (x) mental health. Validated clinical as well as patient-reported outcome measurement instruments were endorsed. Demographic factors, baseline clinical factors, and treatment factors were identified as risk-adjustment variables. CONCLUSION A consensus-based international set of health outcomes relevant to all persons with hemophilia, and corresponding measurement instruments, was identified for use in clinical care to facilitate harmonized longitudinal monitoring and comparison of outcomes.
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Affiliation(s)
- Erna C. van Balen
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | | | - Marjon H. Cnossen
- Department of Pediatric HematologyErasmus University Medical Center – Sophia Children's HospitalRotterdamThe Netherlands
| | - Gerard Dolan
- Centre for Haemostasis and ThrombosisSt Thomas' HospitalLondonUK
| | - Victor S. Blanchette
- Division of Hematology/OncologyDepartment of PediatricsHospital for Sick ChildrenUniversity of TorontoTorontoONCanada
| | - Kathelijn Fischer
- Van CreveldkliniekDepartment of HematologyUniversity Medical Centre UtrechtUtrechtThe Netherlands
| | - Deborah Gue
- British Columbia Provincial Bleeding Disorders Program – Adult DivisionSt. Paul's HospitalVancouverBCCanada
| | - Jamie O'Hara
- Faculty of Health and Social CareUniversity of ChesterChesterUK
| | - Alfonso Iorio
- Department of MedicineMcMaster‐Bayer Endowed Research Chair in Clinical Epidemiology of Congenital Bleeding DisordersMcMaster UniversityHamiltonONCanada
- Department of Health Research Methods, Evidence and ImpactMcMaster‐Bayer Endowed Research Chair in Clinical Epidemiology of Congenital Bleeding DisordersMcMaster UniversityHamiltonONCanada
| | - Shannon Jackson
- British Columbia Provincial Bleeding Disorders Program – Adult DivisionSt. Paul's HospitalVancouverBCCanada
| | - Barbara A. Konkle
- Bloodworks NorthwestSeattleWAUSA
- Department of MedicineUniversity of WashingtonSeattleWAUSA
| | - Diane J. Nugent
- Children's HospitalUniversity of CaliforniaIrvine
- Center for Inherited Blood DisordersOrangeCAUSA
| | | | - Mark W. Skinner
- National Hemophilia FoundationNew YorkNYUSA
- Institute for Policy Advancement LtdWashingtonDCUSA
| | - Cees Smit
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Alok Srivastava
- Department of HaematologyChristian Medical CollegeVelloreIndia
| | - Fred van Eenennaam
- The Decision GroupAmsterdamThe Netherlands
- Erasmus School of Accounting & AssuranceErasmus UniversityRotterdamThe Netherlands
| | - Johanna G. van der Bom
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
- Center for Clinical Transfusion ResearchSanquin/LUMCLeidenThe Netherlands
| | - Samantha C. Gouw
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
- Department of Pediatric HematologyAmsterdam University Medical CenterEmma Children's HospitalUniversity of AmsterdamAmsterdamThe Netherlands
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Hassan S, Monahan RC, Mauser-Bunschoten EP, van Vulpen LFD, Eikenboom J, Beckers EAM, Hooimeijer L, Ypma PF, Nieuwenhuizen L, Coppens M, Schols SEM, Leebeek FWG, Smit C, Driessens MH, le Cessie S, van Balen EC, Rosendaal FR, van der Bom JG, Gouw SC. Mortality, life expectancy, and causes of death of persons with hemophilia in the Netherlands 2001-2018. J Thromb Haemost 2021; 19:645-653. [PMID: 33217158 PMCID: PMC7986360 DOI: 10.1111/jth.15182] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 10/20/2020] [Accepted: 11/10/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Treatment of patients with hemophilia has advanced over the past decades, but it is unknown whether this has resulted in a normal life expectancy in the Netherlands. OBJECTIVE This observational cohort study aimed to assess all-cause and cause-specific mortality in patients with hemophilia in the Netherlands between 2001 and 2018 and to compare mortality and life expectancy with previous survival assessments from 1973 onward. PATIENTS/METHODS All 1066 patients with hemophilia who participated in a nationwide survey in 2001 were followed until July 2018. RESULTS Information on 1031 individuals (97%) was available, of whom 142 (14%) deceased during follow-up. Compared with the general Dutch male population, mortality of patients with hemophilia was still increased (standardized mortality ratio: 1.4, 95% confidence interval: 1.2-1.7). Intracranial bleeding and malignancies were the most common causes of death. Estimated median life expectancy of patients with hemophilia was 77 years, 6 years lower than the median life expectancy of the general Dutch male population (83 years). Over the past 45 years, death rates of patients with hemophilia have consistently decreased, approaching the survival experience of the general population. Over the past decades, mortality due to human immunodeficiency virus and hepatitis C virus infections has decreased, death due to intracranial hemorrhages has increased, and death due to ischemic heart disease has remained consistently low over time. CONCLUSIONS Survival in patients with hemophilia in the Netherlands has improved over time but is still lower than that of the general population.
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Affiliation(s)
- Shermarke Hassan
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rory C Monahan
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Lize F D van Vulpen
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jeroen Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
| | - Erik A M Beckers
- Department of Hematology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Louise Hooimeijer
- Department of Paediatrics, University Medical Center Groningen, Groningen, the Netherlands
| | - Paula F Ypma
- Department of Hematology, HagaZiekenhuis, The Hague, the Netherlands
| | | | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | - Saskia E M Schols
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Frank W G Leebeek
- Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Cees Smit
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Saskia le Cessie
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Erna C van Balen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Johanna G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands
| | - Samantha C Gouw
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands
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39
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Hoefnagels JW, Versloot O, Schrijvers LH, van der Net J, Leebeek FWG, Gouw SC, Fischer K. Sports participation is not associated with adherence to prophylaxis in Dutch patients with haemophilia. Haemophilia 2021; 27:e402-e405. [PMID: 33556987 DOI: 10.1111/hae.14244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/01/2022]
Affiliation(s)
| | - Olav Versloot
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Liesbeth H Schrijvers
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands.,Nursing Department, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Janjaap van der Net
- Center for Child Development, Exercise and Physical Literacy, University Children's Hospital, UMC Utrecht, Utrecht, The Netherlands
| | - Frank W G Leebeek
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Samantha C Gouw
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Kathelijn Fischer
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
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40
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Abdi A, Kloosterman FR, Eckhardt CL, Male C, Castaman G, Fischer K, Beckers EAM, Kruip MJHA, Peerlinck K, Mancuso ME, Santoro C, Hay CR, Platokouki H, van der Bom JG, Gouw SC, Fijnvandraat K, Hart DP. The factor VIII treatment history of non-severe hemophilia A. J Thromb Haemost 2020; 18:3203-3210. [PMID: 32877570 PMCID: PMC7756346 DOI: 10.1111/jth.15076] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/01/2020] [Accepted: 08/18/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND In patients with non-severe hemophilia A, we lack detailed knowledge on the timing of treatment with factor VIII (FVIII) concentrates. This knowledge could provide information about the expected treatment timing in patients with severe hemophilia A treated with non-replacement therapies. OBJECTIVE To assess the FVIII treatment history in patients with non-severe hemophilia A. METHODS Patients with non-severe hemophilia (baseline FVIII activity [FVIII:C] 2-40 IU/dL) were included from the INSIGHT study. The primary outcome was median age at first FVIII exposure (ED1). In a subgroup of patients for whom more detailed information was available, we analyzed the secondary outcomes: median age at first 20 EDs, annualized bleeding rate for all bleeds (ABR), joint bleeds (AJBR), and major spontaneous bleeds (ASmBR). RESULTS In the total cohort (n = 1013), median baseline FVIII activity was 8 IU/dL (interquartile range [IQR] 4-15) and the median age at ED1 was 3.7 years (IQR 1.4-7.7). Median age at ED1 rose from 2.5 years (IQR 1.2-5.7) in patients with FVIII:C 2-5 IU/dL to 9.7 years (IQR 4.8-16.0) in patients with FVIII:C 25-40 IU/dL. In the subgroup (n = 104), median age at ED1, ED5, ED10, and ED20 was 4.0 years (IQR 1.4-7.6), 5.6 years (IQR 2.9-9.3), 7.5 years (IQR 4.4-11.3), and 10.2 years (IQR 6.5-14.2), respectively. Median ABR, AJBR, and ASmBR were 1.1 (IQR 0.5-2.6), 0.3 (IQR 0.1-0.7), and 0 (IQR 0-0), respectively. CONCLUSION This study demonstrates that in non-severe hemophilia A, the age at first FVIII exposure increases with baseline FVIII:C and that major spontaneous bleeds rarely occur.
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Affiliation(s)
- Amal Abdi
- Department of Pediatric HematologyEmma Children's HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Fabienne R. Kloosterman
- Department of Pediatric HematologyEmma Children's HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Corien L. Eckhardt
- Department of Pediatric HematologyEmma Children's HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Christoph Male
- Department of PediatricsMedical University of ViennaViennaAustria
| | - Giancarlo Castaman
- Department of OncologyCenter for Bleeding DisordersCareggi University HospitalFlorenceItaly
| | - Kathelijn Fischer
- Van CreveldkliniekUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Erik A. M. Beckers
- Department of HematologyMaastricht University Medical CenterMaastrichtthe Netherlands
| | | | - Kathelijne Peerlinck
- Department of Cardiovascular SciencesHemophilia CenterUniversity of LeuvenUniversity Hospitals LeuvenLeuvenBelgium
| | - Maria Elisa Mancuso
- Angelo Bianchi Bonomi Hemophilia and Thrombosis CenterFondazione IRCCS Ca' GrandaOspedale Maggiore PoliclinicoMilanItaly
| | | | - Charles R. Hay
- Department of HematologyManchester Royal InfirmaryManchester UniversityManchesterUK
| | - Helen Platokouki
- Haemophilia Centre‐Haemostasis UnitAghia Sophia Children's HospitalAthensGreece
| | - Johanna G. van der Bom
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
- Center for Clinical Transfusion ResearchSanquin ResearchLeidenthe Netherlands
| | - Samantha C. Gouw
- Department of Pediatric HematologyEmma Children's HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric HematologyEmma Children's HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
- Department of Molecular Cellular HemostasisSanquin Research and Landsteiner LaboratoryAmsterdamthe Netherlands
| | - Dan P. Hart
- The Royal London Haemophilia CentreQMULBarts and the London School of Medicine and DentistryLondonUK
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41
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Abdi A, Bordbar MR, Hassan S, Rosendaal FR, van der Bom JG, Voorberg J, Fijnvandraat K, Gouw SC. Prevalence and Incidence of Non-neutralizing Antibodies in Congenital Hemophilia A- A Systematic Review and Meta-Analysis. Front Immunol 2020; 11:563. [PMID: 32457734 PMCID: PMC7221178 DOI: 10.3389/fimmu.2020.00563] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/12/2020] [Indexed: 12/21/2022] Open
Abstract
Objectives: In hemophilia A the presence of non-neutralizing antibodies (NNAs) against Factor VIII (FVIII) may predict the development of neutralizing antibodies (inhibitors) and accelerate the clearance of administrated FVIII concentrates. This systematic review aimed to assess: (1) the prevalence and incidence of NNAs in patients with congenital hemophilia without inhibitors and (2) the association between NNAs and patient and treatment characteristics. Methods: We conducted a search in MEDLINE, Embase, Web of Science and the Cochrane database. We included cross-sectional and longitudinal studies reporting on NNAs in patients with hemophilia A and B, who were inhibitor-negative at the start of the observation period. Data were extracted on: hemophilia type and severity, patient and treatment characteristics, NNA prevalence and incidence, NNA assays and inhibitor development. Two independent reviewers performed study selection, data extraction and risk of bias assessment, using adapted criteria of the Joanna Briggs Institute. Studies were classified as high-quality when ≥5/9 criteria were met. NNA assays were classified as high-quality when both quality criteria were met: (1) use of positive controls and (2) competition with FVIII to establish FVIII-specificity. We reported NNA prevalence and incidence for each study. The pooled NNA prevalence was assessed for well-designed studies in previously treated patients, employing high-quality NNA assays. Results: We included data from 2,723 inhibitor-negative patients with hemophilia A, derived from 28 studies. Most studies were cross-sectional (19/28) and none reported on NNAs in hemophilia B. Study design was of high quality in 16/28 studies and the NNA assay quality was high in 9/28 studies. Various NNA assays were used, predominantly ELISA (18/28) with different cut-off values. We found a large variety in NNA prevalence (Range, 0–100%). The pooled NNA prevalence in high-quality studies was 25% (95% CI, 16–38%). The incidence of new NNA development was reported in one study (0.01 NNA per person-exposure day). Conclusion: This systematic review identified studies that were heterogeneous in study design, patient population and NNA assay type, with NNA prevalence ranging from 0 to 100% in inhibitor-negative patients with hemophilia A. The pooled NNA prevalence was 25% in high-quality studies including only previously treated patients and performing high-quality NNA assays.
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Affiliation(s)
- A Abdi
- Department of Pediatric Hematology, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - M R Bordbar
- Hematology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S Hassan
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - J G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands.,Center for Clinical Transfusion Research, Sanquin Research, Leiden, Netherlands
| | - J Voorberg
- Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, Netherlands.,Department of Experimental Vascular Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - K Fijnvandraat
- Department of Pediatric Hematology, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands.,Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, Netherlands
| | - S C Gouw
- Department of Pediatric Hematology, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
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42
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Balen EC, Krawczyk M, Gue D, Jackson S, Gouw SC, Bom JG, Sawatzky R. Patient‐centred care in haemophilia: Patient perspectives on visualization and participation in decision‐making. Haemophilia 2019; 25:938-945. [DOI: 10.1111/hae.13830] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 06/25/2019] [Accepted: 07/09/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Erna C. Balen
- Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands
| | - Marian Krawczyk
- Lord Kelvin Adam Smith Fellow, School of Interdisciplinary Studies University of Glasgow Glasgow UK
- School of Nursing Trinity Western University Langley Canada
- Centre for Health Evaluation & Outcome Sciences Providence Health Care Research Institute Vancouver Canada
| | - Deborah Gue
- British Columbia Provincial Bleeding Disorders Program ‐ Adult Division St. Paul’s Hospital Vancouver Canada
| | - Shannon Jackson
- British Columbia Provincial Bleeding Disorders Program ‐ Adult Division St. Paul’s Hospital Vancouver Canada
| | - Samantha C. Gouw
- Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands
- Department of Pediatric Hematology, Emma Children’s Hospital Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands
| | - Johanna G. Bom
- Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands
- Sanquin Research Center for Clinical Transfusion Research Leiden The Netherlands
| | - Richard Sawatzky
- School of Nursing Trinity Western University Langley Canada
- Centre for Health Evaluation & Outcome Sciences Providence Health Care Research Institute Vancouver Canada
- Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
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43
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van Balen EC, Gouw SC, Hazelzet JA, van der Bom JG, Cnossen MH. Defining patient value in haemophilia care. Haemophilia 2019; 24:516-518. [PMID: 30141573 DOI: 10.1111/hae.13550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2018] [Indexed: 12/25/2022]
Affiliation(s)
- E C van Balen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherland
| | - S C Gouw
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherland.,Department of Paediatric Haematology, Academic Medical Center Amsterdam, Amsterdam, the Netherland
| | - J A Hazelzet
- Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherland
| | - J G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherland.,Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherland
| | - M H Cnossen
- Department of Paediatric Haematology, Erasmus Medical Center - Sophia Children's hospital, Rotterdam, the Netherlands
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44
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Gouw SC, Timmer MA, Srivastava A, de Kleijn P, Hilliard P, Peters M, Blanchette V, Fischer K. Measurement of joint health in persons with haemophilia: A systematic review of the measurement properties of haemophilia-specific instruments. Haemophilia 2019; 25:e1-e10. [PMID: 30427100 PMCID: PMC7379965 DOI: 10.1111/hae.13631] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 04/20/2018] [Accepted: 05/04/2018] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Accurate assessment of joint health in persons with haemophilia is crucial. Several haemophilia-specific measurement tools are available, but an overview of the measurement properties is lacking. AIM To provide an overview of the measurement properties of haemophilia-specific measurement tools to assess clinical joint health. METHODS MEDLINE and EMBASE were searched for reports on reliability, validity or responsiveness of the World Federation of Haemophilia Orthopedic Joint Score (WFH), Colorado Physical Examination Score (CPE), joint examination score by Petrini (PJS) and Hemophilia Joint Health Score (HJHS). Methodological quality of the studies was assessed using an adapted COSMIN checklist. RESULTS The search yielded 2905 unique hits, and 98 papers were included. The methodological quality of the included studies was limited. The HJHS was studied most extensively, which yielded limited evidence for good internal consistency and structural validity, moderate evidence for hypothesis testing in adults and conflicting evidence for hypothesis testing in children. Reliability, measurement error and responsiveness were rated unknown due to low COSMIN scores. For the CPE and PJS, we found limited to moderate evidence for good responsiveness and conflicting evidence for hypothesis testing. CONCLUSION Only patchy evidence is available on the quality of measurement properties of all haemophilia-specific joint health scores. Although significant gaps in the evidence for all instruments remain, measurement properties of the HJHS were most extensively studied and show no drawbacks for use in clinical practice. This review forms the basis for further research aimed at the assessment of measurement properties of measurement tools to assess joint health.
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Affiliation(s)
- Samantha C. Gouw
- Department of Pediatric HematologyAcademic Medical CenterAmsterdamThe Netherlands
- Department of Clinical EpidemiologyLeiden University Medical CenterAmsterdamThe Netherlands
| | - Merel A. Timmer
- Van Creveldkliniek, Department of HematologyUniversity Medical CenterUtrechtThe Netherlands
| | - Alok Srivastava
- Department of HematologyChristian Medical CollegeVelloreIndia
| | - Piet de Kleijn
- Van Creveldkliniek, Department of HematologyUniversity Medical CenterUtrechtThe Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Pamela Hilliard
- Department of RehabilitationHospital for Sick ChildrenTorontoOntarioCanada
| | - Marjolein Peters
- Department of Pediatric HematologyAcademic Medical CenterAmsterdamThe Netherlands
| | - Victor Blanchette
- Department of Paediatrics, Division of Hematology/Oncology, Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada
| | - Kathelijn Fischer
- Van Creveldkliniek, Department of HematologyUniversity Medical CenterUtrechtThe Netherlands
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45
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Jardim LL, van der Bom J, Brommonschenkel CC, Gouw SC, Rezende SM. Inhibitor incidence in haemophilia A under exclusive use of a third-generation recombinant factor VIII concentrate: results of the HEMFIL Cohort Study. Br J Haematol 2018; 186:152-155. [PMID: 30556277 DOI: 10.1111/bjh.15728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Letícia L Jardim
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Johanna van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands
| | | | - Samantha C Gouw
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Suely M Rezende
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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46
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Hassan S, Cannavò A, Gouw SC, Rosendaal FR, van der Bom JG. Factor VIII products and inhibitor development in previously treated patients with severe or moderately severe hemophilia A: a systematic review. J Thromb Haemost 2018; 16:1055-1068. [PMID: 29665204 DOI: 10.1111/jth.14124] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Indexed: 02/02/2023]
Abstract
Essentials Data on product-related immunogenicity in previously treated haemophilia A patients is scarce. A systematic review and meta-analysis of all currently available evidence was conducted. The overall incidence rate was 2.06 per 1000 person-years (95% confidence interval: 1.06-4.01). Some recombinant factor VIII products were associated with increased immunogenicity. SUMMARY Background Patients with severe hemophilia A who have been treated extensively with factor VIII products have a low but potentially serious risk of inhibitor development. It is unknown why these patients develop inhibitors, and data on product-related immunogenicity are scarce. Aims To summarize the currently available evidence on the relationship between inhibitor development and recombinant FVIII product type in previously treated patients (PTPs) with severe hemophilia A. Methods Longitudinal studies were included that reported on de novo inhibitor formation in patients with baseline FVIII activity levels of < 0.02 IU mL-1 who had been treated with FVIII for at least 50 days. Pooled incidence rates of inhibitor development according to product types were calculated with a random intercept Poisson regression model. Results Forty-one independent cohorts were included; 39 patients developed de novo inhibitors during 19 157 person-years of observation. The overall incidence rate was 2.06 per 1000 person-years, with a 95% confidence interval (CI) of 1.06-4.01. According to product type, the pooled incidence rates were 0.99 (95% CI 0.37-2.70) per 1000 person-years for patients treated with Advate, 5.86 (95% CI 0.25-134.92) per 1000 person-years for those treated with Kogenate/Helixate, 1.35 (95% CI 0.66-2.77) per 1000 person-years for those treated with Kogenate FS/Helixate NexGen, 12.05 (95% CI 1.53-94.78) per 1000 person-years for those treated with Refacto, and 4.64 (95% CI 0.82-26.43) per 1000 person-years for those treated with Refacto AF. Conclusion These results suggest that some products may be associated with increased immunogenicity. However, the low incidence of inhibitors in PTPs and the differences in study design may cause significant variation in estimates of risk.
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Affiliation(s)
- S Hassan
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - A Cannavò
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Luigi Villa Foundation, Milan, Italy
| | - S C Gouw
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Pediatric Hematology, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - J G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands
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Abstract
BACKGROUND Lymphomas are the third most common malignancy in childhood. Cure rates are high but have reached a plateau. Therefore new treatment modalities should be developed. Antibody therapy is a successful new treatment option in adult lymphoma. However, none of the therapeutic antibodies available for adults with cancer have been approved for treatment of paediatric lymphoma. OBJECTIVES To assess the efficacy of antibody therapy for childhood lymphoma in terms of survival, response and relapse rates, compared with therapy not including antibody treatment. To assess quality of life and the occurrence of adverse effects caused by antibody therapy treatment in children compared with therapy not including antibody treatment. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2014, Issue 10), MEDLINE in PubMed (from 1945 to October 2014), EMBASE in EMBASE.com (from 1980 to October 2014) and reference lists of relevant articles. Furthermore, we searched conference proceedings abstracts of SIOP, ASCO and ASH for studies from 2009 to 2013), and the World Health Organization (WHO) ICTRP portal and ClinicalTrials.gov for ongoing trials. SELECTION CRITERIA Randomised controlled trials and controlled clinical trials comparing conventional therapy with antibody therapy in children with lymphoma. DATA COLLECTION AND ANALYSIS Two authors independently performed the study selection. MAIN RESULTS We found no studies meeting the inclusion criteria of the review. AUTHORS' CONCLUSIONS At this moment, it is not possible to draw evidence-based conclusions regarding clinical practice. Phase I and II studies show a positive effect of using antibody therapy in childhood lymphoma. Further research is needed to evaluate and implement antibody therapy for paediatric lymphoma.
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Affiliation(s)
- Verena de Zwart
- Albert Schweitzer HospitalDepartment of PediatricsAlbert Schweitzerplaats 25DordrechtNetherlands3318 AT
| | - Samantha C Gouw
- Emma Children's Hospital/Academic Medical CenterDepartment of Pediatric Hematology, Immunology, Rheumatology and Infectious diseasePO Box 22660AmsterdamNetherlands1100 DD
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de Zwart V, Gouw SC, Meyer-Wentrup FAG. Antibody therapies for lymphoma in children. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2014. [DOI: 10.1002/14651858.cd011181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Gouw SC, van der Bom JG, Ljung R, Escuriola C, Cid AR, Claeyssens-Donadel S, van Geet C, Kenet G, Mäkipernaa A, Molinari AC, Muntean W, Kobelt R, Rivard G, Santagostino E, Thomas A, van den Berg HM. Factor VIII products and inhibitor development in severe hemophilia A. N Engl J Med 2013; 368:231-9. [PMID: 23323899 DOI: 10.1056/nejmoa1208024] [Citation(s) in RCA: 316] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND For previously untreated children with severe hemophilia A, it is unclear whether the type of factor VIII product administered and switching among products are associated with the development of clinically relevant inhibitory antibodies (inhibitor development). METHODS We evaluated 574 consecutive patients with severe hemophilia A (factor VIII activity, <0.01 IU per milliliter) who were born between 2000 and 2010 and collected data on all clotting-factor administration for up to 75 exposure days. The primary outcome was inhibitor development, which was defined as at least two positive inhibitor tests with decreased in vivo recovery of factor VIII levels. RESULTS Inhibitory antibodies developed in 177 of the 574 children (cumulative incidence, 32.4%); 116 patients had a high-titer inhibitory antibody, defined as a peak titer of at least 5 Bethesda units per milliliter (cumulative incidence, 22.4%). Plasma-derived products conferred a risk of inhibitor development that was similar to the risk with recombinant products (adjusted hazard ratio as compared with recombinant products, 0.96; 95% confidence interval [CI], 0.62 to 1.49). As compared with third-generation full-length recombinant products (derived from the full-length complementary DNA sequence of human factor VIII), second-generation full-length products were associated with an increased risk of inhibitor development (adjusted hazard ratio, 1.60; 95% CI, 1.08 to 2.37). The content of von Willebrand factor in the products and switching among products were not associated with the risk of inhibitor development. CONCLUSIONS Recombinant and plasma-derived factor VIII products conferred similar risks of inhibitor development, and the content of von Willebrand factor in the products and switching among products were not associated with the risk of inhibitor development. Second-generation full-length recombinant products were associated with an increased risk, as compared with third-generation products. (Funded by Bayer Healthcare and Baxter BioScience.).
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Affiliation(s)
- Samantha C Gouw
- Department of Pediatrics, Wilhelmina Children's Hospital, Utrecht, The Netherlands
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