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Comorbidity and Mortality in Men and Women With Haemophilia in Three Nordic Countries-Comparisons to Matched Controls
Swedish Inst Hlth Econ, Sweden; Lund Univ, Sweden.
Lund Univ, Sweden; Skåne Univ Hosp, Sweden.
Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden.
Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden.
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2025 (English)In: Haemophilia, ISSN 1351-8216, E-ISSN 1365-2516Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction Comorbidities and public health conditions in haemophilia are receiving increasing attention. Aim To analyse the prevalence of comorbidities and mortality in people with haemophilia (PwH) compared to matched controls in subgroups (factor consumption and sex). Methods This study used longitudinal individual-level data (11 years) from national registers in three Nordic countries (Denmark, Finland and Sweden) from the MIND study (NCT03276130) for PwH and matched controls (1:5 on birth year and sex). It compared the prevalence of arthropathy, human immunodeficiency virus (HIV), hepatitis, depression, anxiety, hypertension, ischaemic heart disease, atrial fibrillation, stroke, diabetes, cancer, kidney disease and epilepsy, and mortality. Three severity subgroups for PwH were identified by use of factor concentrates and sex, including female carriers. Results Data for 2716 PwH (24,921 person-years) were analysed. PwH had increased prevalence of single and multiple comorbidities (p < 0.001), and increased mortality (p < 0.001). Arthropathy was more prevalent in all male PwH subgroups in Nordic countries, and among women including carriers in Sweden (odds ratios: similar to 2 -> 12). Arthropathy was a concomitant comorbidity alongside depression, hypertension, cardiovascular conditions, diabetes, hepatitis and HIV. Hypertension was more prevalent for PwH than controls in most subgroups. Hepatitis and HIV had the highest odds ratios among PwH in Denmark and Sweden. Conclusion Arthropathy occurs in combination with a complex of comorbidities. The potential common pathophysiologic denominator should be further explored. Higher prevalence of comorbidities and mortality rates in men and women with haemophilia call for a holistic approach with more ambitious treatment goals for PwH across severities and sexes. Trial Registration The MIND Study was registered at ClinicalTrials.gov: NCT03276130

Place, publisher, year, edition, pages
WILEY , 2025.
Keywords [en]
arthropathy; case-control studies; comorbidity; haemophilia A; haemophilia B; hypertension; mortality
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:liu:diva-212739DOI: 10.1111/hae.70023ISI: 001447073800001PubMedID: 40099856Scopus ID: 2-s2.0-105000465649OAI: oai:DiVA.org:liu-212739DiVA, id: diva2:1949055
Note

Funding Agencies|Sobi; Costello Medical, UK - Sanofi

Available from: 2025-04-01 Created: 2025-04-01 Last updated: 2025-04-01

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Holmström, Margareta
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Division of Diagnostics and Specialist MedicineFaculty of Medicine and Health SciencesDepartment of Acute Internal Medicine and Geriatrics
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