Similarity in joint function limitation in Type 3 von Willebrand's disease and moderate haemophilia A.

Published

Journal Article

Type 3 von Willebrand's disease (VWD) is a rare bleeding diathesis with complete or near complete deficiency of von Willebrand factor (VWF) and low factor VIII (FVIII) levels. In contrast, only FVIII is decreased in haemophilia A (HA). Both disorders are complicated by arthropathy. The purpose of this study was to further clarify the roles of FVIII and VWF: Antigen (VWF:Ag) in joint range of motion (ROM) loss over time. We compared joint ROM loss and other bleeding manifestations in 100 Type 3 VWD subjects (FVIII<5%) and 1814 moderate HA subjects (FVIII 1-5%) within the U.S. Universal Data Collection (UDC) database. High rates of bleeding were reported at baseline. During follow-up, moderate HA patients reported a joint (46% vs. 34%, P < 0.0001) or muscle bleed (27% vs. 16%, P < 0.0001) in a higher proportion of visits than VWD patients. Other bleeds, including mucosal, were reported in a greater proportion of visits among patients with Type 3 VWD than among those with HA (49% vs. 32%, P < 0.0001). Multivariate analysis revealed no difference in joint ROM loss over time in the Type 3 VWD vs. moderate HA populations. A higher FVIII level was protective in both VWD and HA (P < 0.001). Our findings support the hypothesis of primacy of the FVIII level in determining risk of joint haemorrhage, and may help target therapy in Type 3 VWD and moderate HA to prevent joint disability.

Full Text

Duke Authors

Cited Authors

  • Sood, SL; Cuker, A; Wang, C; Metjian, AD; Chiang, EY; Soucie, JM; Konkle, BA; HTCN Study Investigators,

Published Date

  • July 2013

Published In

Volume / Issue

  • 19 / 4

Start / End Page

  • 595 - 601

PubMed ID

  • 23534856

Pubmed Central ID

  • 23534856

Electronic International Standard Serial Number (EISSN)

  • 1365-2516

Digital Object Identifier (DOI)

  • 10.1111/hae.12119

Language

  • eng

Conference Location

  • England