Hemophilic arthropathy: Current knowledge and future perspectives.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Dr. Gualtierotti is a member of advisory boards of Biomarin, Pfizer, Bayer, and Takeda, and participates in educational seminars sponsored by Pfizer, Sobi, and Roche. Dr. Peyvandi is a member of advisory boards of Bioverativ, Grifols, Roche, Sanofi, Sobi, Spark, and Takeda. Dr. Solimeno has no disclosure to make. 2. Blood Rev. 2025 Nov;74:101304. doi: 10.1016/j.blre.2025.101304. Epub 2025 May 21. Unmet needs in hemophilic arthropathy. Dargaud Y(1), Lobet S(2), Roussel N(3), Valentino LA(4). Author information: (1)French Reference Centre for Hemophilia, Louis Pradel Hospital and UR4609 Haemostasis & Thrombosis Research Unit of the University of Lyon 1, Lyon, France. Electronic address: ydargaud@univ-lyon1.fr. (2)Haemostasis and Thrombosis Unit, Division of Hematology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UC Louvain), Brussels, Belgium; Service d'ergothérapie et de kinésithérapie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UC Louvain), Brussels, Belgium; Neuromusculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain (UC Louvain), Belgium. (3)Faculty of Medicine and Health Sciences, Rehabilitation Sciences and Physiotherapy (MOVANT), University of Antwerp, Antwerp, Belgium. (4)Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago, IL, United States. Hemophilia A and B are rare X-linked bleeding disorders caused by coagulation factor deficiencies, leading to joint bleeding, synovial hypertrophy and chronic hemophilic arthropathy marked by progressive cartilage and bone damage. Musculoskeletal issues remain the primary source of morbidity in people with hemophilia (PwH). Despite significant advances in prophylactic therapies, joint pain, functional limitations, and deterioration persist. The long-term impact of novel treatments on joint health and physical activity levels remains incompletely understood. Early detection and prevention of damage is challenging, highlighting the need for highly sensitive diagnostic tools to identify subclinical changes before irreversible damage occurs. Pain management, currently adapted from other conditions, does not fully meet the unique needs of PwH. Research into targeted pain relief, synovial hypertrophy management, and cartilage regeneration is crucial. Addressing unmet needs in diagnosis, treatment, and management requires collaboration between clinical and research communities to improve care effectiveness and enhance the quality of life for PwH. Copyright © 2025. Published by Elsevier Ltd. DOI: 10.1016/j.blre.2025.101304