Open AccessImpact of the HEAD-US Scoring System for Observing the Protective Effect of Prophylaxis in Hemophilia Patients: A Prospective, Multicenter, Observational Study
Author(s) -
Kaan Kavaklı,
Süha Süreyya Özbek,
Ali Bülent Antmen,
Fahri Şahin,
Şevkiye Selin Aytaç,
Alphan Küpesiz,
Bülent Zülfikar,
Mehmet Sönmez,
Ümran Çalışkan,
Can Balkan,
Tuğana Akbaş,
Taner Arpacı,
İpek Tamsel,
Turgut Seber,
Berna Oğuz,
Can Çevi̇kol,
Mesut Bulakçı,
Polat Koşucu,
Demet Aydoğdu,
İlgen Şaşmaz,
Gülen Tüysüz,
Başak Koç,
Hüseyin Tokgöz,
Zuhal Mehrekula,
Burcu Özkan
Publication year - 2021
Publication title -
turkish journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.351
H-Index - 16
ISSN - 1300-7777
DOI - 10.4274/tjh.galenos.2021.2020.0717
Subject(s) - medicine , observational study , radiological weapon , multicenter study , ultrasonography , prospective cohort study , physical examination , arthropathy , pediatrics , physical therapy , surgery , osteoarthritis , pathology , randomized controlled trial , alternative medicine
Objective: This study aimed to observe the preventive effect of prophylactic treatment on joint health in people with hemophilia (PwH) and to investigate the importance of integration of ultrasonographic examination into clinical and radiological evaluation of the joints. Materials and Methods: This national, multicenter, prospective, observational study included male patients aged ≥6 years with the diagnosis of moderate or severe hemophilia A or B from 8 centers across Turkey between January 2017 and March 2019. Patients were followed for 1 year with 5 visits (baseline and 3 rd , 6 th , 9 th , and 12 th month visits). The Hemophilia Joint Health Score (HJHS) was used for physical examination of joints, the Pettersson scoring system was used for radiological assessment, point-of-care (POC) ultrasonography was used for bilateral examinations of joints, and the Hemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) score was used for evaluation of ultrasonography results. Results: Seventy-three PwH, of whom 62 had hemophilia A and 11 had hemophilia B, were included and 24.7% had target joints at baseline. The HJHS and HEAD-US scores were significantly increased at the 12 th month in all patients. These scores were also higher in the hemophilia A subgroup than the hemophilia B subgroup. However, in the childhood group, the increment of scores was not significant. The HEAD-US total score was significantly correlated with both the HJHS total score and Pettersson total score at baseline and at the 12 th month. Conclusion: The HEAD-US and HJHS scoring systems are valuable tools during follow-up examinations of PwH and they complement each other. We suggest that POC ultrasonographic evaluation and the HEAD-US scoring system may be integrated into differential diagnosis of bleeding and long-term monitoring for joint health as a routine procedure.