OC 12.5 - Correlation of Biomarkers, Conventional X ray score, Hemophilia Joint Healthy Score and Joint Sonography for Assessment of Hemophilic Arthropathy Severity

Sunday, June 25, 2023

11:45 – 12:00 ET

Room: 710A

Session Available As: On-Demand

Presenting Author(s)

Yeu-Chin Chen, MD

Doctor
Hemophilia care & research center, Division of Hematology/Oncology, Tri-Service General Hospital, National Defense Medical Centerr, Taipei, Taiwan
Taipei, Taipei, Taiwan (Republic of China)

Co-Author(s)

Chia-Yau Chang, assistant professor

Doctor
1. Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University; 2. Division of Pediatric Hematology and Oncology, Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan.
Taipei, Taipei, Taiwan (Republic of China)
Shin-Nan Cheng, Medical Doctor

Head
Hemophilia center, Department of Pediatrics, Tungs’ Taichung MetroHarbor Hospital, Taichung
Taipei, Taipei, Taiwan (Republic of China)
Shiue-Wei Lai, PhD

Doctor
Division of Hematology/Oncology, Department of Internal Medicine, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Taipei, Taipei, Taiwan (Republic of China)
TL

Tsung-Ying Li

Doctor
Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, National Defense Medical Center
Taipei, Taipei, Taiwan (Republic of China)
SH

Shu-Hsia Hu

Researcher
Hemophilia Care and Research Center, Tri-Service General Hospital, Taipei, Taiwan.
Taipri, Taipei, Taiwan (Republic of China)

Background: Repeated and recurrent joint bleeding in patients with hemophilia A ( HA ) can lead to hemophilic arthropathy which compromise patients’ quality of life. The aim of this study was to explore whether the serum biochemical markers have correlation with X ray Pettersson’s score, HJHS score and sonographic score on assessment of hemophilic arthropathy.

Aims: To correlate those individual or relevant combinations of biomarkers with HJHS score, sonographic score and X ray Pettersson score assessment for HA severity

Methods: There were 58 HA patients enrolled between January and November, 2021. Most patients had severe type. Patient with factor VIII inhibitor or HIV infection were excluded. Each patient’s hemophilic arthropathy was assessed by radiological X ray, HJHS score and HEAD-US ultrasonography. Ten serum ELISA biomarkers assays evaluating bone, cartilage, synovium, inflammation and angiogenesis were performed for patients and male adult subjects.

Results: The median age of our cohort was 46 years old. The mean score of HEAD-US, HJHS and X ray Pettersson’s score was 19.3, 20.2 and 24.5, respectively ( Table 1 ). As compared to those in normal subjects, there were higher serum COMP, CTX-I, CTX-II, sVCAM-1, osteocalin and osteopontin levels in patients, which had significantly statistical difference. VEGF level was lower in HA patients in comparison with normal subject. There were significant correlation of HEAD-US with COMP ( p=0.006 ) and sVCAM-1 ( p=0.012), respectively ( Figure 1 ), and HJHS with COMP ( p=0.0034 ) and sVCAM-1 ( p=0.0014), respectively. There were positive correlation between Pettersson's score and COMP( p=0.0096 ) and VCAM-1( p=0.0018 ). Pettersson’s score had negative correlation with VEGF ( p=0.021 ).

Conclusion(s): Our study demonstrates that patients with HA had significantly cartilage degradation and inflammation and that there were reasonable correlations of COMP and sVCAM-1 with HEAD-US, HJHS and Pettersson’s score in severe or moderate type HA patients.

Learning Objectives:

Realize which biomarkers have positive correlation with the severity of hemophilic arthorapthy assessed by X ray Pettersson score, physical examination by HJHS and ultrasonography by HEAD-US.
Know whiich clinical factor or biomarker are the positive or negative independent predictors for HJHS score.
Understand which clinical factor or biomarker are the positive or negative independent predictors for the severity of hemophilic arthorpathy assessed by HEAD-US score.