Kucher A, Clearfield E, Germini F, Dubé E, Merlen C, Bonnefoy A, St-Louis J, Rivard G.E, Skinner M. Impact on Pain and Activities of Daily Living after Switching to Emicizumab: Insight from PROBE.(2023), POSTER ABSTRACTS (PO177). Haemophilia, 29: 24-202. https://doi.org/10.1111/hae.14715
Introduction
Emicizumab for treatment of people with severe hemophilia A (SHA) was recently approved by Health Canada. A prospective observational study was initiated to evaluate the efficacy of emicizumab and assess health-related quality of life (HRQoL).
Methods
HRQoL outcomes were collected using the Patient Reported Outcomes Burdens and Experiences (PROBE) questionnaire. Eight male SHA (median age 22.5, range 17-55 years) completed PROBE pre- and ≥ 10 months post-switching to emicizumab. Acute and chronic pain were assessed as any occurrence (recall: 12 months) and during 8 activities (walking, stair climbing, nighttime, resting, weight bearing, playing, after falling/trauma, other). Participants reported pain interference in 11 aspects of life (general activity, walking ability, normal work, attending school, relations with others, sleep, enjoyment of life, playing/participating in sports/exercising, lifting, other). PROBE also includes a 24-item activities of daily living (ADL) list; current difficulty is reported. Descriptive statistics present results for pain outcomes and difficulty with ADL.
Results
The number of SHA reporting any acute pain, chronic pain, or ADL impairment was reduced post switch (7
[87.5%] to 4 [50.0%], 5[62.5%] to 4 [50%], 8 [100%] to 3 [37.5%], respectively). Switching was associated with improvement on self-reported acute and chronic pain occurrence during activities post-switch. Pre-switch SHA reporting acute pain indicated “yes” to the acute pain occurrence in 22 vs 8 cases post-switch. Chronic pain was similarly reduced from 20 to 7. No SHA reported acute or chronic pain occurrences for nighttime and resting post-switch. Reports of pain interference were also reduced: there were more affirmative reports of acute and chronic pain interfering pre-switch compared to post (42 vs 12 and 28 vs 15, respectively). Data also show an association with improvements in ADL from 72 activities reported difficult to perform pre-switch vs 20 post-switch. The most improved ADL post-switch were getting up from sitting, playing games or participating in sport, sleeping/resting, doing heavy domestic tasks.
Discussion/Conclusion
PROBE demonstrated that the introduction of emicizumab is associated with a significant decrease in self-reported acute and chronic pain, as well as reduced interference with activities of daily living.
Disclosure of Interest: Noone D.
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