Obesity in haemophilia patients: effect on bleeding frequency, clotting factor concentrate usage, and haemostatic and fibrinolytic parameters

Tuinenburg, A.; Biere-Rafi, Sara; Peters, M.; Verhamme, Peter; Peerlinck, Kathelijne; Kruip, Marieke J.H.A.; Gorkom, Britta A P Laros-van; Roest, Mark; Meijers, Joost C. M.; Kamphuisen, Pieter Willem; Schutgens, Roger E. G.

doi:10.1111/hae.12182

Cited by 23 publications

(37 citation statements)

References 25 publications

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“…The mechanisms of obesity‐associated arthropathy are yet to be elucidated. Obesity had no effect on bleeding frequency, but was associated with a 1.4 fold increase in the use of clotting factor concentrates in a study comparing 51 obese and 46 non‐obese patients with haemophilia A .…”

Section: Obesity and Its Impact On Complications And Dosingmentioning

confidence: 96%

Medical co‐morbidities of patients with haemophilia: pain, obesity and hepatitis C

Witkop

Peerlinck²,

Luxon

2016

Haemophilia

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Clinical care of patients with haemophilia (PWH) has progressed rapidly over the past decade. Current therapy has allowed patients with haemophilia to live longer and many patients are now experiencing the co-morbidities of the general population. In this review article, we focus on three common diseases states that affect PWH: chronic pain, obesity and hepatitis C. Pain has been a co-morbidity for many years and PWH often have unusual needs for chronic pain relief compared to the general population. Obesity is not only increasing in the general population but also in patients with hereditary bleeding disorders. The co-morbidity of obesity not only causes increased pain progression and joint damage but also affects the dosing of factor concentrates. Finally, hepatitis C is known to have infected the majority of patients who received non-virally inactivated pooled factor concentrates in the past. New treatment regimens have been developed that allow the nearly uniform cure of chronic hepatitis C with a short course of oral medications.

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Section: Obesity and Its Impact On Complications And Dosingmentioning

confidence: 96%

Medical co‐morbidities of patients with haemophilia: pain, obesity and hepatitis C

Witkop

Peerlinck²,

Luxon

2016

Haemophilia

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“…68 Some studies have found ~65% of haemophilia patients to be Vitamin D deficient; low vitamin D levels have a strong association with osteoporosis in haemophilia patients. 39,70,71 Therefore, optimizing vitamin D and achievement of an ideal BMI are crucial. 39,70,71 Therefore, optimizing vitamin D and achievement of an ideal BMI are crucial.…”

Section: General Considerations Throughout the Lifespanmentioning

confidence: 99%

Optimizing bleed prevention throughout the lifespan: Womb to Tomb

Gupta

Shapiro

2018

Haemophilia

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The focus of care providers, patients and families is the ability to tailor care for persons with haemophilia (PWH) across the lifespan. Care requires knowledge of the bleeding disorder and age-related complications, risk of therapeutic interventions, and evaluation of individual characteristics that contribute to outcomes. The ultimate goal is to live a normal life without the burden of bleeding, for PWH and carriers. A wide range of therapeutic options is required to achieve personalized care. Over the last decade, substantial therapeutic advantages have been achieved in the treatment of haemophilia that include the development of a robust array of factor concentrates, novel haemostatic agents, and increased knowledge and awareness of disease associated outcomes and risk factors. Significant strides on the road to accessible gene therapy have been realized. This increased range of therapeutic modalities provides options for development and implementation of care plans for each patient at each stage of life that are more flexible compared to prior care regimens. Paradigms for management of haemophilia are changing. As a community, we must work together to use these resources wisely, to learn from outcomes with new therapies and diagnostic tools, to assure all patients can achieve improved care and outcomes regardless of disease state or country of origin.

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“…This disease is classified as mild, moderate or severe, depending on the level of clotting factor VIII or IX in an individual's blood. 3,6,16,17 Limited data exist on the longitudinal impact of obesity and changes of weight, which are mostly derived from case reports. [2][3][4][5][6][7] In people with haemophilia (PwH), the prevalence of overweight (adults, 19%-59%; children, 15%-21%) and obesity (adults, 18%-36%; children, 17%-22%) is similar to that of the general US population.…”

Section: Introductionmentioning

confidence: 99%

Awareness, Care and Treatment In Obesity maNagement to inform Haemophilia Obesity Patient Empowerment (ACTION‐TO‐HOPE): Results of a survey of US patients with haemophilia and obesity (PwHO) and their partners and caregivers

et al. 2020

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Background:The ACTION study identified barriers to initiating and maintaining weight loss in patients with obesity; however, joint-related issues (pain, mobility and bleeding) may affect perceptions of patients with haemophilia and obesity (PwHO). Aim:To identify patient and caregiver insights on the unique challenges of PwHO.Methods: Following IRB approval, adults who self-identified as PwHO, spouses/partners of adult PwHO, and caregivers of adolescent PwHO (aged 12-17 years) com- Results:Respondents included 124 adult PwHO, 45 spouses/partners and 42 caregivers. By calculated BMI, most adults were overweight (43%) or had obesity (51%); this differed from self-reported weight category. PwHO goals were improving health conditions (60%), having more energy (54%), reducing risks of weight (46%), and losing any weight (44%). Issues related to joint health were secondary for PwHO but frequently reported by spouses/parents. Most perceived weight loss to be a high priority (66%) and their responsibility (64%) but required a complete lifestyle change (63%).Most anticipated that weight loss would reduce joint pain (62%), bleeding (58%) and factor use (52%) and increase mobility (62%). Weight discussions with healthcare providers (HCPs) were commonly reported (51%). HCP discussions targeted improving health conditions (46%), achieving any weight loss (44%), being more active (73%) and improving eating habits (72%). Most PwHO (65%) perceived obesity as a disease and believe that 10% weight loss would be extremely beneficial (78%). In the past 5 years, 80% discussed being overweight and 68% losing weight; a minority reported being successful (9%) or somewhat successful (38%) with weight loss. More realistic or specific (51%/47%) goals, resources (46%), referrals to weight-loss programmes (41%) or dietitians (38%), meals or recipes (54%/50%), local or national (42%/41%) programmes for PwHO and success stories of PwHO (40%) are needed or would be helpful. Conclusions:PwHO, spouse/partners and caregivers exhibited awareness of general and haemophilia-specific consequences of excess body weight. Most have tried

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Obesity in haemophilia patients: effect on bleeding frequency, clotting factor concentrate usage, and haemostatic and fibrinolytic parameters

Cited by 23 publications

References 25 publications

Medical co‐morbidities of patients with haemophilia: pain, obesity and hepatitis C

Medical co‐morbidities of patients with haemophilia: pain, obesity and hepatitis C

Optimizing bleed prevention throughout the lifespan: Womb to Tomb

Awareness, Care and Treatment In Obesity maNagement to inform Haemophilia Obesity Patient Empowerment (ACTION‐TO‐HOPE): Results of a survey of US patients with haemophilia and obesity (PwHO) and their partners and caregivers

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