Clotting factor activity levels and bleeding risk in people with haemophilia playing sports

Author:

Versloot Olav12,Kemler Ellen3,Blokzijl Johan1,Timmer Merel1,Schuuring Marleen4,van Galen Karin P. M.1,Kremer Hovinga Idske Cornelia L.1,van der Valk Paul R.1,van Vulpen Lize F. D.1,Schutgens Roger E. G.1,van Koppenhagen Casper F.5,van der Net Janjaap4,Fischer Kathelijn1

Affiliation:

1. Centre for Benign Haematology Thrombosis and Haemostasis Van Creveldkliniek University Medical Center Utrecht Utrecht University Utrecht The Netherlands

2. Department of Physiotherapy Institute of Movement Studies University of Applied Science Utrecht Utrecht The Netherlands

3. Dutch Consumer Safety Institute Utrecht Amsterdam The Netherlands

4. Center for Child Development Exercise and Physical Literacy University Children's Hospital University Medical Center Utrecht University Utrecht The Netherlands

5. Rehabilitation Medicine Erasmus Medical Center Rotterdam The Netherlands

Abstract

AbstractBackgroundImproved treatment options for people with haemophilia (PWH) have increased the possibilities for sports participation, but the risk of sports‐induced bleeding (SIB) is still considered considerable by many.AimTo assess sports associated injury‐ and bleeding risk in PWH and to assess clotting levels associated with safe sports participation.MethodsSports injuries and SIBs were prospectively collected for 12 months in PWH aged 6–49 without inhibitors playing sports at least once weekly. Injuries were compared according to factor levels, severity, joint health, sports risk category and sports intensity. Factor activity at the time of injury was estimated using a pharmacokinetic model.Results125 participants aged 6–49 (41 children, 90% haemophilia A; 48% severe, 95% severe on prophylaxis) were included. Sports injuries were reported by 51 participants (41%). Most participants (62%) reported no bleeds at all and only 16% reported SIBs. SIBs were associated with factor levels at time of injury (OR: 0.93/%factor level (CI 0.88–0.99); p = .02), but not with haemophilia severity (OR: 0.62 (CI 0.20–1.89); p = .40), joint health, sports risk category or sports intensity. PWH with factor levels <10% during sports injury had a bleeding risk of 41% versus 20% in those with higher (>10%) factor levels.ConclusionThe results of this study emphasize the importance of clotting factor levels in prevention of bleeds. This information is vital for patient counselling and tailoring prophylactic treatment with clotting factors and non‐replacement therapy.

Funder

Bayer

Publisher

Wiley

Subject

Genetics (clinical),Hematology,General Medicine

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