Emerging clinical concerns in the ageing haemophilia patient

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The availability of safe replacement clotting factor concentrates together with effective antiviral drugs to treat human immunodeficiency and hepatitis C viruses and the provision of care at designated haemophilia treatment centres have resulted in a new phenomenon in haemophilia management – the ageing patient. Today, increasing numbers of persons with haemophilia (PWH) are middle-aged and older, and they face the same age-related health issues as the general population. The impact of these risks on PWH is unclear, however, and there is a paucity of information about how to manage comorbidities in this patient population. This review focuses on five comorbidities that uniquely affect older PWH: cardiovascular disease, liver disease, cancer, renal disease and joint disease. Available research is summarized and potential management approaches are suggested.

Keywords: ageing; comorbidities; haemophilia

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-2516.2009.02066.x

Affiliations: 1: Penn Comprehensive Hemophilia Program, University of Pennsylvania School of Medicine, Philadelphia, PA, USA 2: Georgetown University Hospital, Lombardi Cancer Center, Washington, DC, USA 3: Mount Sinai School of Medicine, New York, NY, USA 4: DMC Karmanos Cancer Institute Comprehensive Center for Bleeding Disorders and Thrombosis, Detroit, MI, USA 5: University of California at San Francisco, San Francisco, CA, USA 6: Mary M. Gooley Hemophilia Center, Rochester, NY, USA 7: Orthopaedic Hospital of Los Angeles, Hemophilia Treatment Center, Los Angeles, CA, USA 8: University of Pittsburgh Medical Center and Hemophilia Center of Western Pennsylvania, Pittsburgh, PA, USA 9: Northwestern University, Division of Hematology/Oncology, Chicago, IL, USA 10: Baxter Healthcare, Westlake Village, CA, USA

Publication date: November 1, 2009

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