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Lookup NU author(s): Dr Katherine Talks
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© 2024 The Authors. Haemophilia published by John Wiley & Sons Ltd.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.
Author(s): Laffan M, McLaughlin P, Motwani J, Alamelu J, Austin S, Classey S, Dolan G, Eales M, Gooding R, Grainger J, Harrison C, Jones A, Kelly AM, Oyesiku L, Rodgers R, Stephensen D, Talks K, Sonecha S, Danquah A
Publication type: Article
Publication status: Published
Journal: Haemophilia
Year: 2024
Volume: 30
Issue: 2
Pages: 306-319
Print publication date: 01/03/2024
Online publication date: 19/01/2024
Acceptance date: 30/12/2023
Date deposited: 25/03/2024
ISSN (print): 1351-8216
ISSN (electronic): 1365-2516
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1111/hae.14934
DOI: 10.1111/hae.14934
Data Access Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
PubMed id: 38239180
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