How to assess, detect, and manage joint involvement in the era of transformational therapies: Role of point-of-care ultrasound
Journal article
Stephensen, D., DiMinno, M. N. D., Martinoli, C., Pasta, G., DelaCorte-Rodriguez, H., Samy, I., Timmer, M. and Winburn, I. 2023. How to assess, detect, and manage joint involvement in the era of transformational therapies: Role of point-of-care ultrasound. Haemophilia. 29, pp. 1-10. https://doi.org/10.111/hae.14657
Authors | Stephensen, D., DiMinno, M. N. D., Martinoli, C., Pasta, G., DelaCorte-Rodriguez, H., Samy, I., Timmer, M. and Winburn, I. |
---|---|
Abstract | Background: Patients with haemophilia experience recurring hemarthroses, mainly involving knees, elbows and ankles, which lead to haemophilic arthropathy, the major chronic complication of haemophilia. With new approaches to haemophilia treatment leading to fewer joint bleeds and, in some cases, no bleeding events, assessing whether current outcome assessment tools provide adequate sensitivity and specificity for management and care of patients with haemophilia is needed. Methods: An overview of current imaging tools for monitoring joint health, novel osteochondral damage and synovial proliferation biomarkers, and the relationship between assessments for functionality and imaging modalities is provided. Usefulness and sensitivity of point-of-care ultrasound (POCUS) to complement other assessments and use of ultrasound to monitor haemophilic arthropathy are also examined. Results: This review provides rationale for haemophilia teams to move beyond traditional outcomes in joint imaging, as well as guidance and evidence on assessment of joint health for potential new treatment modalities, such as gene therapy. The role of POCUS in the existing paradigm for haemophilia care and management along with the use of ultrasound as a complement to other outcome assessment tools are also discussed. Finally, the clinical effects of subclinical bleeding on joint function are described, to motivate screening for synovial proliferation. Conclusion: POCUS can facilitate the early detection of joint damage and can monitor disease progression while providing insights into the efficacy of treatment regimens and should be considered as an essential assessment tool for managing the care of patients with haemophilia. |
Keywords | Haemarthrosis; Haemophilia A; Haemorrhage; Joint diseases; Ultrasound |
Year | 2023 |
Journal | Haemophilia |
Journal citation | 29, pp. 1-10 |
Publisher | Wiley |
ISSN | 1351-8216 |
1365-2516 | |
Digital Object Identifier (DOI) | https://doi.org/10.111/hae.14657 |
Official URL | https://onlinelibrary.wiley.com/doi/abs/10.1111/hae.14657 |
Funder | Pfizer |
Publication dates | |
Online | 26 Sep 2022 |
Publication process dates | |
Deposited | 22 Nov 2023 |
Output status | Published |
https://repository.canterbury.ac.uk/item/9663z/how-to-assess-detect-and-manage-joint-involvement-in-the-era-of-transformational-therapies-role-of-point-of-care-ultrasound
42
total views1
total downloads2
views this month0
downloads this month