Ogawa Yoshiyuki, Amano Kagehiro, Sugao Yoshimasa, Nosaka Daisuke, Murakami Yoichi, Adachi Hiroki, Nogami Keiji
Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan.
Haemophilia. 2025 Jan;31(1):99-107. doi: 10.1111/hae.15132. Epub 2024 Dec 18.
Acquired haemophilia A (AHA) is characterized by the development of autoantibodies against factor VIII, reducing its activity and potentially resulting in bleeding.
To assess the characteristics of people with AHA undergoing rehabilitation and/or with low activities of daily living (ADL) scores, thereby characterizing unmet needs in the management of AHA and informing treatment optimization.
ORIHIME II, the largest epidemiological and treatment survey of AHA in Japan, is a descriptive, retrospective, observational study conducted using health claims data from April 2008 to October 2021. The primary outcome measures were rehabilitation practice and ADL scores on hospital admission and discharge; use of haemostatic agents and immunosuppressive therapy were also assessed.
Overall, 427 patients in Japan were eligible for the study. Median (Q1-Q3) age was 78.0 (70.0-84.0) years; 264 patients (61.8%) were male. Median (Q1-Q3) time to start rehabilitation was 9 (4-21) and 14 (6-31) days for those with an admission ADL score of <85 and ≥85, respectively. Of the 427 patients, 249 underwent rehabilitation. The most common rehabilitation type was for disuse syndrome; haemostatic agents were more commonly used in patients undergoing earlier rehabilitation.
The physical condition of the patient at hospitalization was associated with rehabilitation practice and the ability of the patient to perform day-to-day activities independently. Treatment strategies should be optimized to allow initiation of rehabilitation as early as possible in the course of AHA.
获得性血友病A(AHA)的特征是产生针对凝血因子VIII的自身抗体,降低其活性并可能导致出血。
评估接受康复治疗和/或日常生活活动(ADL)评分较低的AHA患者的特征,从而确定AHA管理中未满足的需求并为治疗优化提供依据。
ORIHIME II是日本最大规模的AHA流行病学和治疗调查,是一项描述性、回顾性观察性研究,使用2008年4月至2021年10月的健康保险理赔数据进行。主要结局指标是入院和出院时的康复实践和ADL评分;还评估了止血剂和免疫抑制治疗的使用情况。
总体而言,日本有427名患者符合研究条件。年龄中位数(四分位间距)为78.0(70.0 - 84.0)岁;264名患者(61.8%)为男性。入院ADL评分<85分和≥85分的患者开始康复的时间中位数(四分位间距)分别为9(4 - 21)天和14(6 - 31)天。在427名患者中,249名接受了康复治疗。最常见的康复类型是废用综合征;止血剂在早期接受康复治疗的患者中使用更为普遍。
患者住院时的身体状况与康复实践以及患者独立进行日常活动的能力相关。应优化治疗策略,以便在AHA病程中尽早开始康复治疗。