Comorbidity and Mortality in Men and Women With Haemophilia in Three Nordic Countries–Comparisons to Matched Controls

IF 3 2区医学 Q2 HEMATOLOGY

Haemophilia Pub Date : 2025-03-18 DOI:10.1111/hae.70023

Katarina Steen Carlsson, Jan Astermark, Fariba Baghaei, Elisabeth Brodin, Eva Funding, Margareta Holmström, Klaus Österholm, Sofia Bergenstråle, Stefan Lethagen

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引用次数: 0

Abstract

Introduction

Comorbidities and public health conditions in haemophilia are receiving increasing attention.

Aim

To analyse the prevalence of comorbidities and mortality in people with haemophilia (PwH) compared to matched controls in subgroups (factor consumption and sex).

Methods

This study used longitudinal individual-level data (11 years) from national registers in three Nordic countries (Denmark, Finland and Sweden) from the MIND study (NCT03276130) for PwH and matched controls (1:5 on birth year and sex). It compared the prevalence of arthropathy, human immunodeficiency virus (HIV), hepatitis, depression, anxiety, hypertension, ischaemic heart disease, atrial fibrillation, stroke, diabetes, cancer, kidney disease and epilepsy, and mortality. Three severity subgroups for PwH were identified by use of factor concentrates and sex, including female carriers.

Results

Data for 2716 PwH (24,921 person-years) were analysed. PwH had increased prevalence of single and multiple comorbidities (p < 0.001), and increased mortality (p < 0.001). Arthropathy was more prevalent in all male PwH subgroups in Nordic countries, and among women including carriers in Sweden (odds ratios: ∼2→12). Arthropathy was a concomitant comorbidity alongside depression, hypertension, cardiovascular conditions, diabetes, hepatitis and HIV. Hypertension was more prevalent for PwH than controls in most subgroups. Hepatitis and HIV had the highest odds ratios among PwH in Denmark and Sweden.

Conclusion

Arthropathy occurs in combination with a complex of comorbidities. The potential common pathophysiologic denominator should be further explored. Higher prevalence of comorbidities and mortality rates in men and women with haemophilia call for a holistic approach with more ambitious treatment goals for PwH across severities and sexes.

Trial Registration

The MIND Study was registered at ClinicalTrials.gov: NCT03276130

Abstract Image

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北欧三个国家血友病男性和女性的合并症和死亡率——与匹配对照的比较

血友病的合并症和公共卫生状况正受到越来越多的关注。目的：分析血友病患者（PwH）的合并症患病率和死亡率，并与亚组（因素消耗和性别）的匹配对照进行比较。方法：本研究使用来自三个北欧国家（丹麦、芬兰和瑞典）的纵向个人水平数据（11年），这些数据来自MIND研究（NCT03276130）的PwH和匹配对照（出生年份和性别1:5）。它比较了关节病、人类免疫缺陷病毒（HIV）、肝炎、抑郁、焦虑、高血压、缺血性心脏病、心房颤动、中风、糖尿病、癌症、肾脏疾病和癫痫的患病率以及死亡率。根据因子浓度和性别（包括女性携带者）确定PwH的三个严重程度亚组。结果：分析了2716例PwH（24,921人年）的数据。PwH的单一和多重合并症发生率增高(p结论：关节病发生时伴有复杂的合并症。潜在的共同病理生理因素有待进一步探讨。男性和女性血友病患者中较高的合并症患病率和死亡率要求采取整体方法，对不同严重程度和性别的PwH制定更雄心勃勃的治疗目标。试验注册：MIND研究在ClinicalTrials.gov注册：NCT03276130。

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来源期刊

Haemophilia 医学-血液学

CiteScore

6.50

自引率

28.20%

发文量

226

审稿时长

3-6 weeks

期刊介绍： Haemophilia is an international journal dedicated to the exchange of information regarding the comprehensive care of haemophilia. The Journal contains review articles, original scientific papers and case reports related to haemophilia care, with frequent supplements. Subjects covered include: clotting factor deficiencies, both inherited and acquired: haemophilia A, B, von Willebrand''s disease, deficiencies of factor V, VII, X and XI replacement therapy for clotting factor deficiencies component therapy in the developing world transfusion transmitted disease haemophilia care and paediatrics, orthopaedics, gynaecology and obstetrics nursing laboratory diagnosis carrier detection psycho-social concerns economic issues audit inherited platelet disorders.