The burden of bleeding in haemophilia: is one bleed too many?

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The burden of bleeding in haemophilia: is one bleed too many?A. Gringeri1,*, B. Ewenstein2 andA. Reininger1Article first published online: 29 JAN 2014

DOI: 10.1111/hae.12375

© 2014 John Wiley & Sons Ltd

Issue

HaemophiliaVolume 20, Issue 4, pages 459–463, July 2014

Additional Information

How to CiteGringeri, A., Ewenstein, B. and Reininger, A. (2014), The burden of bleeding in haemophilia: is one bleed too many?. Haemophilia, 20: 459–463. doi: 10.1111/hae.12375

Author Information1

Baxter Innovations GmbH, Vienna, Austria

2

Baxter Healthcare Corporation, Westlake Village, CA, USA

* Correspondence: Alessandro Gringeri, MD, MSc, Baxter Innovations GmbH, Donau City Strasse 7, 1220 Vienna, Austria.
Tel.: +43 (0) 1 20100 247 6226; fax: +43 (0) 1 20100 247 5733;
e-mail: alessandro_gringeri@baxter.com

Publication HistoryIssue published online: 20 JUN 2014Article first published online: 29 JAN 2014Manuscript Accepted: 13 DEC 2013 SEARCH Search Scope All contentPublication titlesIn this journalIn this issue Search String Advanced >Saved Searches > SEARCH BY CITATION Volume: Issue: Page: ARTICLE TOOLSGet PDF (147K)Save to My ProfileE-mail Link to this ArticleExport Citation for this ArticleGet Citation AlertsRequest Permissions AbstractArticleReferencesCited By View Full Article (HTML) Enhanced Article (HTML) Get PDF (147K) Keywords:haemarthrosis;haemophilia;joint bleeding prophylaxis;quality of lifeSummary

Joint bleeding is the hallmark of haemophilia. Increasingly, the pain, restricted movement and anxiety provoked by even a single haemarthrosis are concerns for patients, families and treating physicians. The aims of this study were to determine whether the current paradigm for prophylaxis requires a shift in focus from reducing the frequency of bleeding episodes to a goal of zero bleeding and to review and discuss the published data from in vitro and animal experiments and clinical studies in patients with haemophilia that describe the impact of joint bleeding. More than two to three bleeding into the same joint may cause irreversible and progressive structural damage that compromise health-related quality of life (HRQoL). A goal of zero bleeding episodes – or as close to zero as possible – is key to enhancing joint health and HRQoL in children and adults with haemophilia. Achieving this goal requires individualized, outcome-based, multidisciplinary care to maximize prophylactic efficacy without increasing overall health care costs.

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