The role of a 3-year period of continuous prophylactic concentrate substitution on later development of haemophilic arthropathy

Abstract

This study evaluated the effect of a period of up to 3 years of continuous prophylactic clotting factor concentrate therapy in haemophilia on the degree of arthropathy as measured 10-15 years later. Left and right elbows, knees and ankles of 115 severe and moderate haemophiliacs were evaluated clinically and radiographically after 13.9 years of follow-up, on average, after the period of prophylactic treatment. The average age at final evaluation was 15.4 years. Three groups were compared: (1) Group D, patients treated on demand only; (2) Group D + P, patients treated on demand except for a period of prophylaxis between 1978 and 1981, and (3) six patients who had had inhibitors for more than 10 years. The results were analysed by assessing the degree of change in the 'patient score', i.e. the sum of the orthopaedic scores for the six joints. No statistical differences were found among the study groups. Thus, no benefit of the earlier 3-year period of prophylaxis could be demonstrated.