Treatment Pattern and Pain Related to Joint Bleeds and Non-joint Bleeds - real Life Data According to Electronic Diary Smart-medication^TM

Background: Joint bleeds in patients with haemophilia A/B may cause severe pain leading to immediate or delayed factor treatment, as well as different dosing in home settings.

Methods: Result from 277 patients from 9 haemophilia centers during 2017 were analyzed according to electronic data from smart medication^TM. Severity of pain (SP) on a scale of 1 (very mild) to 10 (very severe) was related to the respective initial treatment dose as well as time gap between joint bleed (JB) or non-JB (muscle and others).

Results: A total of 1403 bleeds were documented, among these 589 as JBs. The annual rate of JBs was 2.13. The initial treatment dose (IU/kg BW) following JBs varied from 23.54 (SP 9) to 62.55 (SP 3). Severe pain (SP 8-10) was followed by treatment doses of 23.54 to 27.94. The time between bleeding symptom and treatment ranged from < 1 hour in 36% to >4 hours in 13%. 25% could not specify any time gap. No major difference concerning dose or treatment delay was seen between JBs and non-JBs.

Conclusions: The initial dose of factor VIII or IX home treatment was independent from severity of pain showing highest doses with a SP of 3. The time gap between bleeding symptoms and factor consumption was mostly < 1 hour or not applicable, independent of whether JBs or non-JBs were documented.

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