The issue of poor bone health represents a significant public health concern in the U.S. population, including for individuals with hemophilia who are at increased risk for low bone mineral density (BMD) and bone fractures. While low BMD in hemophilia has been the focus of previous studies – linked to recurrent joint bleeding, decreased weight bearing, and immobility – less is understood about this complication in other groups. Hemophilia carriers (HCs) and persons with von Willebrand disease (PWvVWD) are two such groups.
A team of investigators therefore conducted a population level, retrospective study to learn more about the prevalence of osteoporosis, osteoarthritis, and bone fractures in both HCs and PWvWD. The study, led by hematologist Divyaswathi Citla-Sridha, MD at the University of Arkansas for Medical Sciences, was published on April 13, 2022, in the journal Haemophilia.
Citla-Sridha and colleagues reviewed de-identified electronic health record data culled from 26 major integrated healthcare systems, encompassing 360 hospitals. 940 HCs and another 19,580 PWvWD were identified. The prevalence of osteoporosis, osteoarthritis, and fractures were reported to be “significantly higher” among both the HC and PWvWD data groups.
Within the HC group, investigators observed higher rates of risk factors often associated with low BMD, including vitamin D deficiency, obesity, hypothyroidism, smoking, corticosteroid use, malignancy, and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). The prevalence of risk factors was also higher in the PWvWD group. In light of these findings, the authors signal the need to screen these patients for risk factors for poor bone health, while also providing education to prevent complications.
“This study highlights the need for Haemophilia Treatment Centres to focus on the bone health in these patients and pay closer attention to other risk factors during their routine comprehensive visits,” concluded the authors. “Further prospective, multi centre studies are necessary to validate these findings."
Source: HCP Live, April 15, 2022
