AB1134 Determining factors of severity in hemophilic arthropathy

Abstract

BackgroundIn patients with haemophilia, the development of inhibitors to factor VIII/IX (Haemophilia A and B, HA/HB), prevents adequate replacement therapy and results in increased risk of serious bleeding episodes, poor control of joint bleeding, and progressive, debilitating joint disease.ObjectivesTo describe, according to the Arnold-Hilgartner scale (AHRS), the radiological findings in a cohort of hemophilic arthropathy (HArth) patients and to analyse the relationship that may exist between the degree of joint involvement and HA/HB, severity, age and presence or absence of inhibitor.MethodsThis is a retrospective study, carried out in the Haemophilia Unit of our hospital, in patients with HArth (2007–2017). Severity of haemophilia: percentage of coagulation factor (CF) activity, moderate (1%–5%) and severe <1%. The AHRS includes 5 levels.For the study of the association of the type and degree of haemophilia; and the presence of inhibitor, with the level in the AHRS, a linear model was used. The significance in this regard of the linear contrasts of interest was studied using F tests, defining the first species error at 0.05.ResultsWe included 88 patients. Characteristics of the patients in the attached chart. No significant association was detected between the type and severity of haemophilia with the development of inhibitor.The results of the linear model only showed association (p=0.01) between the severity of haemophilia and AHRS, patients with moderate haemophilia presented a least square mean for the AHRS of 2.6 (0.3), whereas the serious ones had a value of 3.4 (0.2). The least squared means for patients with HA and HB were 2.9 (0.2) and 3.1 (0.4) respectively, the contrast did not reach statistical significance (p>0.1), and the same occurred between patients who had generated or not inhibitor 2.8 (0.2) Vs 3.1 (0.3). Apart from the severity of haemophilia, the other factor that showed a significant and significant effect (p<0.001) on the AHRS values was age. The estimated value for the regression coefficient of age on the radiological status was 0.05 (0.009).Abstract AB1134 – Table 1Type of Haemophilia Haemophilia A n (%)73 (82%)Haemophilia B n (%)14 (15%)Severity of HaemophiliaHaemophilia A severe n (%)50 (56%)Haemophilia A moderate n (%)23 (26%)Haemophilia B severe n (%)13 (14%)Haemophilia B moderate n (%)1 (1%)Age m (SD)31 (17)Development of inhibitors to factor VIII/IX n (%)16 (18%)Haemophilia A severe with inhibitors n (%)10 (11%)Haemophilia A moderate with inhibitors n (%)3 (3%)Haemophilia B severe with inhibitors n (%)3 (3%)AHRS scale 1 n (%)18 (20%)AHRS scale 2 n (%)17 (19%)AHRS scale 3 n (%)18 (20%)AHRS scale 4 n (%)15 (17%)AHRS scale 5 n (%)19 (21%)ConclusionsContrary to what has been observed in other studies, in our cohort it does not seem that the presence of inhibitor or the type of haemophilia has a negative effect on the severity of the radiological findings. The age and severity of haemophilia do seem to influence the radiological stage.Disclosure of InterestNone declared