Therapeutic problems in elderly patients with hemophilia

Area of Science:

• Hematology
• Geriatrics
• Internal Medicine

Background:

• Increased life expectancy in hemophilia patients due to clotting factor concentrates.
• Aging hemophilia population presents complex comorbidities including arthropathy, viral infections (HCV, HBV, HIV), and organ-specific diseases.
• Hepatitis C virus (HCV) infection leads to liver cirrhosis in a significant percentage of patients.

Purpose of the Study:

• To outline current recommendations for antithrombotic therapy in hemophilia patients with acute coronary syndromes and atrial fibrillation.
• To highlight the challenges and necessary approaches for managing aging hemophilia patients.
• To emphasize the need for a comprehensive diagnostic and therapeutic strategy.

Main Methods:

• Review of current recommendations for antithrombotic therapy.
• Discussion of age-related complications in hemophilia.
• Emphasis on multidisciplinary care approaches.

Main Results:

• Aging hemophilia patients require careful monitoring of cardiovascular risk factors to prevent ischemic heart disease.
• Urgent need for intensive physiotherapy and orthopedic treatment for arthropathy.
• High-risk surgeries necessitate specialized centers with experienced teams and coagulation labs.
• Older patients with mild hemophilia face inhibitor development risk with intensive factor therapy.
• Pain management and quality of life are significant concerns.

Conclusions:

• An increasing number of older hemophilia patients necessitates a comprehensive, multidisciplinary approach.
• Specialized hematological centers are preferred for managing complex cases.
• Addressing arthropathy, viral infections, cardiovascular risks, and pain is vital for improving quality of life.