Volume 16, Issue 2 (June 2024 2024)                   Iranian Journal of Blood and Cancer 2024, 16(2): 102-110 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Abdolkarimi B, Rostami J, Varehzardi F, Tabibian S, Panahi N. Impact of Low-Dose Alendronate Therapy on Target Joints in Hemophilia Patients in a Low-Income Country. Iranian Journal of Blood and Cancer 2024; 16 (2) :102-110
URL: http://ijbc.ir/article-1-1536-en.html
1- Lorestan University of Medical Sciences, Khorramabad, Iran
2- Iranian Comprehensive Hemophilia Care Center, Tehran, Iran
3- Health service management, Science and Research branch, Islamic Azad University,Tehran, Iran
Abstract:   (425 Views)
Background: Osteoporosis poses a significant clinical challenge for patients with hemophilia (PWH), primarily due to repeated intra-articular bleeding and joint inflammation. The objective of this study was to assess the impact of a combination of calcium-vitamin D and alendronate tablets on reducing the frequency of hemarthrosis in PWH in Lorestan province.
Methods: This non-randomized controlled trial involved a total of 118 PWH, out of which 55 patients with severe hemophilia A and B. Each patient underwent two assessments including the frequency and duration of bleeding episodes, and improvement in chronic joint pain, before and after receiving a combination of calcium-vitamin D, alendronate, tranexamic acid, and capsaicin ointment. Variables were measured at six-month intervals (at the beginning and end of the study). The statistical software used was SPSS version 21.
Results: The average age of the patients was 33.99 ± 10.67 years. The average number of target joints was 4.18 ± 0.88. A significant correlation was observed between the number of bleeding episodes before and after medication intake (p <0.0001). Similarly, a correlation was found between pre- and post-medication atrophy around the target joint in PWH (p <0.0001). However, no association was detected between joint ankylosis before and after drug administration (p = 0.5). Importantly, there was an improvement in chronic pain post-medication (p <0.0001).
Conclusion: The findings suggest that the combination of calcium-vitamin D and low-dose intermittent alendronate can improve hemophilia joint condition.
Full-Text [PDF 503 kb]   (86 Downloads)    
: Original Article | Subject: Pediatric Hematology & Oncology
Received: 2024/04/3 | Accepted: 2024/07/7 | Published: 2024/07/23

References
1. Hoots WK, Rodriguez N, Boggio L, Valentino LA. Pathogenesis of haemophilic synovitis: clinical aspects. Haemophilia. 2007 Nov;13 Suppl 3:4-9. [DOI:10.1111/j.1365-2516.2007.01533.x]
2. Rodriguez-Merchan EC. Haemophilic synovitis: basic concepts. Haemophilia. 2007 Nov;13 Suppl 3:1-3. [DOI:10.1111/j.1365-2516.2007.01532.x]
3. Gilbert MS, Cornwall R. The history of synoviorthesis in haemophilia. Haemophilia. 2001 Jul;7 Suppl 2:3-5. [DOI:10.1046/j.1365-2516.2001.00101.x]
4. Dunn CJ, Galinet LA, Wu H, Nugent RA, Schlachter ST, Staite ND, et al. Demonstration of novel anti-arthritic and anti-inflammatory effects of diphosphonates. J Pharmacol Exp Ther. 1993 Sep;266(3):1691-8.
5. Albayrak C, Albayrak D. Vitamin D levels in children with severe hemophilia A: an underappreciated deficiency. Blood Coagul Fibrinolysis. 2015 Apr;26(3):285-9. [DOI:10.1097/MBC.0000000000000237]
6. Saag KG, Emkey R, Schnitzer TJ, Brown JP, Hawkins F, Goemaere S, et al. Alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis. Glucocorticoid-Induced Osteoporosis Intervention Study Group. N Engl J Med. 1998 Jul 30;339(5):292-9. [DOI:10.1056/NEJM199807303390502]
7. Li M, Zhang ZL, Liao E yuan, Chen D cai, Liu J, Tao T zun, et al. Effect of low-dose alendronate treatment on bone mineral density and bone turnover markers in Chinese postmenopausal women with osteopenia and osteoporosis. Menopause. 2013 Jan;20(1):72-8. [DOI:10.1097/gme.0b013e31825fe2e8]
8. DiMichele D, Neufeld EJ. HEMOPHILIA. Hematol Oncol Clin North Am. 1998 Dec;12(6):1315-44. [DOI:10.1016/S0889-8588(05)70054-X]
9. Rotblat F, Goodall AH, O'Brien DP, Rawlings E, Middleton S, Tuddenham EG. Monoclonal antibodies to human procoagulant factor VIII. J Lab Clin Med. 1983 May;101(5):736-46.
10. Hoyer LW. Hemophilia A. N Engl J Med. 1994 Jan 6;330(1):38-47. [DOI:10.1056/NEJM199401063300108]
11. Dargaud Y, Meunier S, Negrier C. Haemophilia and thrombophilia: an unexpected association! Haemophilia. 2004 Jul;10(4):319-26. [DOI:10.1111/j.1365-2516.2004.00906.x]
12. Tomschi F, Ransmann P, Hilberg T. Aerobic exercise in patients with haemophilia: A systematic review on safety, feasibility and health effects. Haemophilia. 2022 May 28;28(3):397-408. [DOI:10.1111/hae.14522]
13. Eid MA, Ibrahim MM, Aly SM. Effect of resistance and aerobic exercises on bone mineral density, muscle strength and functional ability in children with hemophilia. Egyptian Journal of Medical Human Genetics. 2014 Apr;15(2):139-47. [DOI:10.1016/j.ejmhg.2013.12.002]
14. Nowak-Göttl U, Escuriola C, Kurnik K, Schobess R, Horneff S, Kosch A, et al. Haemophilia and thrombophilia. What do we learn about combined inheritance of both genetic variations? Hamostaseologie. 2003 Feb;23(1):36-40. [DOI:10.1055/s-0037-1619560]
15. Naderi A, Nikvarz M, Arasteh M, Shokoohi M. Osteoporosis/osteopenia and hemophilic arthropathy in severe hemophilic patients. Arch Iran Med. 2012 Feb;15(2):82-4.
16. SANTAGOSTINO E, MANCUSO ME, TRIPODI A, CHANTARANGKUL V, CLERICI M, GARAGIOLA I, et al. Severe hemophilia with mild bleeding phenotype: molecular characterization and global coagulation profile. Journal of Thrombosis and Haemostasis. 2010 Apr;8(4):737-43. [DOI:10.1111/j.1538-7836.2010.03767.x]
17. Kurnik K, Kreuz W, Horneff S, Düring C, Schobess R, Bidlingmaier C, et al. Effects of the factor V G1691A mutation and the factor II G20210A variant on the clinical expression of severe hemophilia A in children--results of a multicenter studys. Haematologica. 2007 Jul;92(7):982-5. [DOI:10.3324/haematol.11161]
18. Gebetsberger J, Schirmer M, Wurzer WJ, Streif W. Low Bone Mineral Density in Hemophiliacs. Front Med (Lausanne). 2022;9:794456. [DOI:10.3389/fmed.2022.794456]
19. Hedner U, Ginsburg D, Lusher JM, High KA. Congenital Hemorrhagic Disorders: New Insights into the Pathophysiology and Treatment of Hemophilia. Hematology Am Soc Hematol Educ Program. 2000;241-65. [DOI:10.1182/asheducation.V2000.1.241.20000241]
20. Kasper CK. Hereditary plasma clotting factor disorders and their management. Haemophilia. 2000 Jul;6 Suppl 1:13-27. [DOI:10.1046/j.1365-2516.2000.00042.x]
21. Ebbevi D, Essén A, Forsberg HH. Persons with rheumatoid arthritis challenge the relevance of the health assessment questionnaire: a qualitative study of patient perception. BMC Musculoskelet Disord. 2017 May 12;18(1):189. [DOI:10.1186/s12891-017-1566-5]
22. Pasta G, Annunziata S, Polizzi A, Caliogna L, Jannelli E, Minen A, et al. The Progression of Hemophilic Arthropathy: The Role of Biomarkers. Int J Mol Sci. 2020 Oct 2;21(19). [DOI:10.3390/ijms21197292]
23. Knobe K, Berntorp E. Haemophilia and joint disease: pathophysiology, evaluation, and management. J Comorb. 2011;1:51-9. [DOI:10.15256/joc.2011.1.2]
24. Chailurkit L or, Aunphongpuwanart S, Ongphiphadhanakul B, Jongjaroenprasert W, Sae-tung S, Rajatanavin R. Efficacy of intermittent low dose alendronate in Thai postmenopausal osteoporosis. Endocr Res. 2004 Feb;30(1):29-36. [DOI:10.1081/ERC-120028385]
25. Kuijlaars IAR, van der Net J, Feldman BM, Aspdahl M, Bladen M, de Boer W, et al. Evaluating international Haemophilia Joint Health Score (HJHS) results combined with expert opinion: Options for a shorter HJHS. Haemophilia. 2020 Nov;26(6):1072-80. [DOI:10.1111/hae.14180]
26. Abdelwahab M, Elsayed N. Radiological and clinical evaluation of hemophilic arthropathy in Egyptian patients. Vol. 68, Acta Pediatr Esp. 2010.
27. Di Minno MND, Pasta G, Airaldi S, Zaottini F, Storino A, Cimino E, et al. Ultrasound for Early Detection of Joint Disease in Patients with Hemophilic Arthropathy. J Clin Med. 2017 Jul 31;6(8). [DOI:10.3390/jcm6080077]

Add your comments about this article : Your username or Email:
CAPTCHA

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 All Rights Reserved | Iranian Journal of Blood and Cancer

Designed & Developed by : Yektaweb