ArticleClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
Joint Bleeding Tendencies in Adult Patients With Hemophilia: It's Not All Pharmacokinetics.
Article in Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Point-of-care musculoskeletal ultrasound for hemophilic arthropathy: a scoping review of scanning protocols by the Imaging Expert Working Group of the International Prophylaxis Study Group.Research and practice in thrombosis and haemostasis · 2025Article
- Article
- AAV mediated repression of Neat1 lncRNA combined with F8 gene augmentation mitigates pathological mediators of joint disease in haemophilia.Journal of cellular and molecular medicine · 2024Article
- Pharmacokinetic-Pharmacodynamic Modelling in Hemophilia A: Relating Thrombin and Plasmin Generation to Factor VIII Activity After Administration of a VWF/FVIII Concentrate.European journal of drug metabolism and pharmacokinetics · 2024Article
- Minimum factor VIII levels to prevent joint bleeding in mild hemophilia A.Blood advances · 2023Article
- Exploration of the minimum necessary FVIII level at different physical activity levels in pediatric patients with hemophilia A.Frontiers in pediatrics · 2022Article
- How do we optimally utilize factor concentrates in persons with hemophilia?Hematology. American Society of Hematology. Education Program · 2021Review
- A semiquantitative color Doppler ultrasound scoring system for evaluation of synovitis in joints of patients with blood-induced arthropathy.Insights into imaging · 2021Article
- Asymptomatic Joint Bleeding and Joint Health in Hemophilia: A Review of Variables, Methods, and Biomarkers.Journal of blood medicine · 2021Review
- Emerging benefits of Fc fusion technology in the context of recombinant factor VIII replacement therapy.Haemophilia : the official journal of the World Federation of Hemophilia · 2020Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hemophilic arthropathy from joint bleeding remains a complication with major morbidity in the increasingly aging patients with hemophilia. Prophylactic clotting factor infusions, based on pharmacokinetic dosing to reduce bleeding rates, are being explored more and more. However, there is little evidence on the benefits of pharmacokinetic dosing in direct association with bleeding events. Here, we prospectively followed a cohort of adult patients with hemophilia A and B (n = 26) and arthropathic joints on various clotting factor products over a period of 2 years with clinical and radiographic joint health assessments, frequent joint ultrasound, and pharmacokinetic studies. Joint bleeds and synovitis with synovial vascularity changes were objectively diagnosed by musculoskeletal ultrasound and power Doppler and analyzed in relation to pharmacokinetic, joint- and patient-specific parameters. Results revealed that, contrary to common beliefs, bleeding episodes were not readily explained by pharmacokinetic features, as they were not associated with more time spent below certain clotting factor thresholds. Joint bleeding was found to be associated with prominent vascularity changes, suggesting that vascular remodeling and leakiness may contribute to joint bleeding that cannot be prevented by clotting factor replacement alone.
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Registered trials
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