Gao Hua, Liu Jia, Zhou Shiqiu, Gao Jing, Tan Jing, Chen Rong
Department of Hematology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu Second Clinical College of Chongqing Medical University, Chengdu, People's Republic of China.
Hematology. 2025 Dec;30(1):2439061. doi: 10.1080/16078454.2024.2439061. Epub 2025 Jan 12.
Whether intermediate-dose tertiary prophylaxis can improve quality of life and psychological health in adults with severe/moderate hemophilia A has not been determined. This research aims to explore the impact of intermediate-dose tertiary prophylaxis with recombinant human FVIII (rhFVIII) on quality of life, anxiety and depression in such individuals transitioned from on-demand treatment.
This retrospective analysis collected data from July 2019 to July 2022. Haemophilia Quality of Life Questionnaire for Adults (HAEMO-QoL-A), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) were compared before and after prophylaxis. Additionally, functional independence and joint status were analyzed at the end of the 3-year prophylaxis period, as well as their correlations with HAEMO-QoL-A, PHQ-9, and GAD-7.
The HAEMO-QoL-A total score decreased after prophylaxis (pre-prophylaxis: 88.90 ± 33.38 vs. post-prophylaxis: 79.59 ± 22.89) ( = 0.016). The mean PHQ-9 scores before and after prophylaxis were 4.44 ± 4.63 and 5.56 ± 4.30 ( = 0.058), respectively, while the mean GAD-7 scores were 3.15 ± 3.84 and 4.44 ± 3.99 ( = 0.016). Significant correlations were observed for HAEMO-QoL-A with functional independence ( < 0.001), mood and emotions with age ( = 0.032), PHQ-9 scores with knee joint rehabilitation scores ( = 0.047), and GAD-7 scores with treatment experience and ankle joint rehabilitation scores ( = 0.029, = 0.039).
Intermediate-dose tertiary prophylaxis with rhFVIII can improve quality of life but not relieve anxiety and depression in adults with severe/moderate hemophilia A. Better functional independence correlates with improved quality of life. Gait and age also influence the quality of life to some extent. We need to undertake anxiety and depression screening and provide psychological treatment when necessary.
中等剂量的三级预防能否改善中重度甲型血友病成人的生活质量和心理健康状况尚未确定。本研究旨在探讨从按需治疗过渡到使用重组人FVIII（rhFVIII）进行中等剂量三级预防对这类个体的生活质量、焦虑和抑郁的影响。
本回顾性分析收集了2019年7月至2022年7月的数据。比较了预防前后的成人血友病生活质量问卷（HAEMO-QoL-A）、患者健康问卷-9（PHQ-9）和广泛性焦虑障碍量表-7（GAD-7）。此外，在3年预防期结束时分析了功能独立性和关节状况，以及它们与HAEMO-QoL-A、PHQ-9和GAD-7的相关性。
预防后HAEMO-QoL-A总分下降（预防前：88.90±33.38 vs.预防后：79.59±22.89）（P = 0.016）。预防前后PHQ-9的平均得分分别为4.44±4.63和5.56±4.30（P = 0.058），而GAD-7的平均得分分别为3.15±3.84和4.44±3.99（P = 0.016）。观察到HAEMO-QoL-A与功能独立性显著相关（P < 0.001），情绪与年龄相关（P = 0.032），PHQ-9得分与膝关节康复得分相关（P = 0.047），GAD-7得分与治疗经验和踝关节康复得分相关（P = 0.029，P = 0.039）。
rhFVIII中等剂量三级预防可改善中重度甲型血友病成人的生活质量，但不能缓解焦虑和抑郁。更好的功能独立性与生活质量改善相关。步态和年龄也在一定程度上影响生活质量。我们需要进行焦虑和抑郁筛查，并在必要时提供心理治疗。
