Synovitis and joint health in patients with haemophilia: Statements from a European e-Delphi consensus study
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Synovitis and joint health in patients with haemophilia: Statements from a European e-Delphi consensus study. / Mancuso, Maria Elisa; Holstein, Katharina; O'Donnell, James S; Lobet, Sébastien; Klamroth, Robert; FVIII Think Tank Study Group.
in: HAEMOPHILIA, Jahrgang 29, Nr. 2, 03.2023, S. 619-628.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Synovitis and joint health in patients with haemophilia: Statements from a European e-Delphi consensus study
AU - Mancuso, Maria Elisa
AU - Holstein, Katharina
AU - O'Donnell, James S
AU - Lobet, Sébastien
AU - Klamroth, Robert
AU - FVIII Think Tank Study Group
N1 - © 2023 The Authors. Haemophilia published by John Wiley & Sons Ltd.
PY - 2023/3
Y1 - 2023/3
N2 - INTRODUCTION: Synovitis, a common feature in haemophilia, is triggered by the presence of blood in joints, and represents the first step towards the development of chronic arthropathy. Synovitis may be detected early by means of ultrasound or magnetic resonance imaging scan; clinical joint scores are less sensitive in this setting. Regular long-term prophylaxis with clotting factor concentrates, as primary prophylaxis and tailored to individual needs, has high efficacy in preventing synovitis. In general, higher factor levels lower bleeding risk, but no direct correlation between factor levels and synovitis incidence has been demonstrated.AIM: This study aimed to develop an expert consensus relating to the definition, pathophysiology, diagnosis, prevention, follow-up and treatment of synovitis, recognising its relevance for joint health and taking into account existing knowledge gaps.METHODS: A Delphi consensus study was designed and performed. An expert group prepared 22 statements based on existing literature; a wider expert panel subsequently voted on these.RESULTS: Retention of panellists was high. Four statements required amending and consensus on all statements was achieved after three rounds of voting.CONCLUSION: This e-Delphi consensus study addressed the importance of synovitis in joint health of people with haemophilia and highlighted knowledge gaps in this field. Studies on the natural course of synovitis are lacking and the biological mechanisms underlying this process are not yet fully elucidated. While basic and clinical research proceeds in this field, expert consensus can help guide clinicians in their routine clinical practice, and Delphi methodology is often used to produce best-practice guidelines.
AB - INTRODUCTION: Synovitis, a common feature in haemophilia, is triggered by the presence of blood in joints, and represents the first step towards the development of chronic arthropathy. Synovitis may be detected early by means of ultrasound or magnetic resonance imaging scan; clinical joint scores are less sensitive in this setting. Regular long-term prophylaxis with clotting factor concentrates, as primary prophylaxis and tailored to individual needs, has high efficacy in preventing synovitis. In general, higher factor levels lower bleeding risk, but no direct correlation between factor levels and synovitis incidence has been demonstrated.AIM: This study aimed to develop an expert consensus relating to the definition, pathophysiology, diagnosis, prevention, follow-up and treatment of synovitis, recognising its relevance for joint health and taking into account existing knowledge gaps.METHODS: A Delphi consensus study was designed and performed. An expert group prepared 22 statements based on existing literature; a wider expert panel subsequently voted on these.RESULTS: Retention of panellists was high. Four statements required amending and consensus on all statements was achieved after three rounds of voting.CONCLUSION: This e-Delphi consensus study addressed the importance of synovitis in joint health of people with haemophilia and highlighted knowledge gaps in this field. Studies on the natural course of synovitis are lacking and the biological mechanisms underlying this process are not yet fully elucidated. While basic and clinical research proceeds in this field, expert consensus can help guide clinicians in their routine clinical practice, and Delphi methodology is often used to produce best-practice guidelines.
KW - Humans
KW - Hemophilia A/complications
KW - Delphi Technique
KW - Synovitis/complications
KW - Joint Diseases
KW - Consensus
U2 - 10.1111/hae.14734
DO - 10.1111/hae.14734
M3 - SCORING: Journal article
C2 - 36622258
VL - 29
SP - 619
EP - 628
JO - HAEMOPHILIA
JF - HAEMOPHILIA
SN - 1351-8216
IS - 2
ER -