Treatment with radiosynoviorthesis in hemophilic patients with and without inhibitor.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declare that there is no conflict of interest. 13. Haemophilia. 2025 Sep;31(5):1054-1065. doi: 10.1111/hae.70102. Epub 2025 Aug 2. Managing Haemophilic Arthropathy in People With Haemophilia in Japan: An Informal Consensus. Ono K(1), Nagao A(2), Inagaki Y(3), Amano K(4), Goto M(5), Kaneda M(6), Makino K(7), Nagae C(8), Sawada A(9), Shirayama R(10), Suzuki N(11), Takeyama M(12), Yamasaki N(13), Takedani H(14). Author information: (1)Division of Therapeutic Development for Intractable Bone Diseases, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan. (2)Department of Hematology and Oncology, Kansai Medical University Hospital, Osaka, Japan. (3)Department of Rehabilitation Medicine, Nara Medical University, Kashihara, Japan. (4)Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan. (5)Rehabilitation Center, The University of Tokyo Hospital, Tokyo, Japan. (6)Department of Paediatrics, Sapporo Tokushukai Hospital, Sapporo, Japan. (7)Department of Rehabilitation Medicine, Shin-Ouji Hospital, Kitakyushu, Japan. (8)Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan. (9)Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Japan. (10)Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan. (11)Department of Transfusion Medicine, Nagoya University Hospital, Nagoya, Japan. (12)Division of Hemophilia, Osaka National Hospital, Osaka, Japan. (13)Division of Transfusion Medicine, Hiroshima University Hospital, Hiroshima, Japan. (14)Department of Rehabilitation, NHO Tsuruga Medical Center, Tsuruga, Japan. INTRODUCTION: People with haemophilia who develop haemophilic arthropathy experience disabling physical effects, limiting functionality and quality of life (QOL). Although Clinical Practice Guidelines are available for haemophilia management, consensus on haemophilic arthropathy management is needed. AIM: To develop recommendations for haemophilic arthropathy management in people with haemophilia adapted to the Japanese medical setting. METHODS: Using an informal consensus method, a steering group of 14 clinical experts (orthopaedic, rehabilitation, paediatric, and haematology) in Japan developed 40 literature-based statements and 18 sub-statements related to haemophilic arthropathy management in people with haemophilia. A panel of 30 experts was surveyed by email about their level of agreement with each statement/sub-statement. Responses were tabulated to determine the level of agreement with each statement/sub-statement: strong consensus, consensus, non-consensus, and strong non-consensus. RESULTS: The survey was completed by 27/30 respondents. Strong consensus/consensus was reached for 39 statements/sub-statements, non-consensus/strong non-consensus was reached for four (all related to pain assessment and management), and consensus/non-consensus was not reached for 15. CONCLUSION: Based on insights from a wide range of clinical experts, recommendations for the management of haemophilic arthropathy in people with haemophilia in Japan were developed to aid in addressing the unique challenges faced by healthcare providers in the country. The survey findings indicate that diagnostic tools are needed to aid in haemophilic arthropathy diagnosis. Routine evaluations (physical function, joint ultrasound, QOL, and psychological), activities (physical therapy, rehabilitation, aerobic exercise, and sports), appropriate pain management, and proactive screening for osteoporosis are important when managing haemophilic arthropathy in people with haemophilia. © 2025 The Author(s). Haemophilia published by John Wiley & Sons Ltd. DOI: 10.1111/hae.70102 PMCID: PMC12462597