PAIN ASSESSMENT AND MANAGEMENT IN HAEMOPHILIA: A SURVEY AMONG ITALIAN PATIENTS AND SPECIALIST PHYSICIANS

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People with haemophilia face pain from an early age, with the onset of joint bleeding and the onset of arthropathy, which is related to recurrent joint bleeds. In adolescence and adulthood, the prevalence of haemophiliacs experiencing pain increases, as does the impact of pain in their lives.

In this scenario, a survey has described the perception of pain and its management in people with haemophilia in Italy, both from the point of view of patients and doctors.

The first information retrieved indicates that patients’ pain perception is quite different from that of physicians. Specifically, the percentage of patients reporting chronic pain and suffering was 15% higher than that reported by physicians, while data on patients with acute pain more than double.

Identification of optimal pharmacological treatments for chronic pain remains an unmet need. Implementation and optimisation of customised prophylaxis regimens with standard or extended half-life FVIII/FIX concentrates, taking into account individual clinical needs, could improve patient outcomes, including pain. As such, physicians report that chronic arthropathic pain was the primary reason for switching from on-demand treatment to prophylaxis in 52% of patients.

This first Italian survey revealed discrepancies in awareness of the problem of pain in haemophilia between patients and physicians, highlighting the need to accurately address this clinical challenge through standardised procedures for pain assessment and management.

Reference:

Tagliaferri A, Franchini M, Rivolta GF, Farace S, Quintavalle G, Coppola A; on behalf of the ad hoc Study Group. Pain assessment and management in haemophilia: A survey among Italian patients and specialist physicians. Haemophilia. 2018;24:766–773. https://doi. org/10.1111/hae.13600

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Wikiphilia

Learn more about the meaning of the words you read on this page and learn about the entire glossary on hemophilia.

The process by which the medicinal product passes from the point of administration into the plasma, by crossing biological membranes.

In the case of factor VIII, administration is via the intravenous route, which makes absorption immediate.

A protein present in connective tissue. It is the most plentiful protein found in the human body.

A protein belonging to the clotting factor category, a group of enzymes involved in the blood-clotting process.

It is encoded by a gene on the long arm of the X chromosome.

Factor VIII is also known as anti-haemophilic factor (AHF).

Product containing a high concentration of freeze-dried factor VIII, used for replacement therapy in the treatment of haemophilia A.

A bleed that occurs in a joint, i.e. the point at which two bones meet.

Haemarthroses are the most common bleeding events in patients with haemophilia and cause the swelling and redness of the joint, which becomes warm and painful.

The joint’s prolonged exposure to the inflammation generated by the build-up of blood can lead to the development of joint disease.

A ereditary genetic illness, characterised by a deficiency of clotting factor VIII, that exposes the individual to a greater risk of both internal and external bleeds.

Haemophilia A is more common in males, whereas females tend to be healthy carriers of the condition.

The typical symptoms of the condition include haemarthroses (joint bleeds) and haematomas (muscle bleeds).

Damage that occurs in the joints and prevents their normal function, thereby impairing the individual’s ability to move normally. In haemophiliac patients, joint disease is usually the consequence of recurrent haemarthroses.

Condition that occurs when factor VIII activity is between 1% and 5%.

Treatment regimen usually used in patients with severe haemophilia A.

It involves the constant, regular administration of the lacking factor VIII, in order to prevent bleeds.

Therapy for the treatment of haemophilia A, consisting in the intravenous administration of the lacking factor VIII, thereby restoring a correct blood-clotting process and preventing bleeds.

Replacement therapy can be administered in accordance with two treatment regimens: as on-demand or prophylactic therapy.

Condition that occurs when factor VIII activity is <1%.

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PAIN ASSESSMENT AND MANAGEMENT IN HAEMOPHILIA: A SURVEY AMONG ITALIAN PATIENTS AND SPECIALIST PHYSICIANS

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Wikiphilia

Absorption of the medicinal product

Collagen

Factor VIII

Factor VIII concentrate

Haemarthrosis

Haemophilia A

Joint disease

Mild haemophilia A

Moderate haemophilia A

Prophylactic therapy

Replacement therapy

Severe haemophilia A