Expert United Kingdom consensus on the preservation of joint health in people with moderate and severe haemophilia A: A modified Delphi panel.
Haemophilia
; 30(2): 306-319, 2024 Mar.
Article
en En
| MEDLINE
| ID: mdl-38239180
ABSTRACT
AIM:
For people with haemophilia A (PwHA), bleeding in the joints leads to joint damage and haemophilia-related arthropathy, impacting range of motion and life expectancy. Existing guidelines for managing haemophilia A support healthcare professionals (HCPs) and PwHA in their efforts to preserve joint health. However, such guidance should be reviewed, considering emerging evidence and consensus as presented in this manuscript.METHODS:
Fifteen HCPs experienced in the management of PwHA in the UK participated in a three-round Delphi panel. Consensus was defined at ≥70% of panellists agreeing or disagreeing for Likert-scale questions, and ≥70% selecting the same option for multiple- or single-choice questions. Questions not reaching consensus were revised for the next round.RESULTS:
26.8% (11/41), 44.8% (13/29) and 93.3% (14/15) of statements reached consensus in Rounds 1, 2 and 3, respectively. HCPs agreed that prophylaxis should be offered to patients with a baseline factor VIII (FVIII) level of ≤5 IU/dL and that, where there is no treatment burden, the aim of prophylaxis should be to achieve a trough FVIII level ≥15 IU/dL and maintain a longer period with FVIII levels of ≥20-30 IU/dL to provide better bleed protection. The aspirational goal for PwHA is to prevent all joint bleeds, which may be achieved by maintaining normalised (50-150 IU/dL) FVIII levels.CONCLUSION:
The panel of experts were largely aligned on approaches to preserving joint health in PwHA, and this consensus may help guide HCPs.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Hemofilia A
Tipo de estudio:
Guideline
Límite:
Humans
País como asunto:
Europa
Idioma:
En
Año:
2024
Tipo del documento:
Article