Noone D, Chai-Adisaksopha C, Curtis R, Frick N, Nichol M, O’Mahony B, Page D, Pastarnak A, Stonebraker J, Iorio A, Skinner M. Predictors For Acute And Chronic Pain In Patients With Severe Haemophilia In The PROBE Cohort. Poster Presentations #P080. Haemophilia. 2019;25(S1):35-188. https://doi.org/10.1111/hae.13666
Introduction
For people with severe haemophilia, acute and chronic pain is often part of their daily reality. We looked at the extent to which this pain was influenced by annual bleed rate, presence of target joints or joints with reduced range of motion.
Methods
A binary regression analysis was performed to measure the association of acute and chronic pain with selected predictors from the PROBE Phase 2 data. The dependent variable (outcome) was the likelihood of reporting chronic and acute pain. The 5 predictor variables includedin the model were: age, reported annual bleeding rate (ABR), current treatment, presence of a target joint and range of motion (ROM) in a joint.
Results
There were 1287 respondents from 21 countries in total, 658 of whom had severe haemophilia and information for the predictor variables. For acute pain, the univariate logistic regression analysis showed a significant association for ABR (all bleeds) with patients reporting 2-3 bleeds/year being 2.9 times more likely to report acute pain compared to those with 0-1 bleeds/year, and those reporting more than 15 bleeds/year being 10.3 times more likely. Those reporting the presence of a target joint were 2.0 times more likely to report acute pain than thosewithout a target joint. In the full model (all 5 predictors) the impact of ABR is reduced but remains significant. Overall, the full model only predicts 13% of the variation in those who report acute pain. For chronic pain models, the univariate model predicts that those with 2-3 bleeds/year and >15 bleeds/year are 2.2 and 5.5 times more likely to report chronic pain compared to those with 0-1 bleeds/year, explaining 14% of the variance in chronic pain. In the full model however, the most responsible predictor was the presence of a joint with reduced ROM, withthose reporting a limitation being 5 times more likely to report chronic pain than those with full range of motion, which explains 23% of the variance.
Discussion/Conclusion
Our predictors were found to correlate with acute and chronic pain. While acute pain is primarily driven
by the frequency of bleeding and the presence of a target joint, chronic pain is primarily driven by the presence of a joint with reduced range of motion. Therefore, it would be worth exploring whether treatment regimens targeted to reduce annual bleeding rates or those aimed at improving the range of motion would be more effective in reducing chronic pain.
Disclosure of Interest
D. Noone Grant/Research support from: Baxalta, now part of Shire; Bayer; Bioverativ, a Sanofi Company; CSLBehring; Novo Nordisk, Roche and Sobi and the collaboration of the US National Hemophilia Foundation, Chai-Adisaksopha: None Declared, R. Curtis: None Declared, N. Frick: None Declared, M. Nichol: None Declared, B. O’Mahony: None Declared, D. Page: None Declared, A. Pastarnak: None Declared, J. Stonebraker: None Declared, A. Iorio: None Declared, M. Skinner: None Declared
View Poster: Predictors For Acute And Chronic Pain
