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Author(s)

Mindy L. Simpson, MD

Department of Pediatrics, Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago, Illinois

Disclosures

Disclosure: Mindy L. Simpson, MD, has disclosed no relevant financial relationships.

Leonard A. Valentino, MD

Department of Pediatrics, Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago, Illinois

Disclosures

Disclosure: Leonard A. Valentino, MD, has disclosed no relevant financial relationships.

Editor

Elisa Manzotti

Publisher, Future Science Group, London, United Kingdom

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Disclosure: Elisa Manzotti has disclosed no relevant financial relationships.

CME Author(s)

Laurie Barclay, MD

Freelance writer and reviewer, Medscape, LLC

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Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

CME Reviewer(s)

Nafeez Zawahir, MD

CME Clinical Director, Medscape, LLC

Disclosures

Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

CME

Management of Joint Bleeding in Hemophilia

Authors: Mindy L. Simpson, MD; Leonard A. Valentino, MD
CME Released: 9/20/2012
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 9/20/2013, 11:59 PM EST

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Target Audience and Goal Statement

This activity is intended for hematologists, radiologists, pediatricians, and other clinicians caring for patients with joint bleeding due to hemophilia.

The goal of this activity is to review the clinical presentation and management of hemarthrosis in patients with hemophilia.

Upon completion of this activity, participants will be able to:

Describe the clinical characteristics of joint bleeding in hemophilia
Describe prophylaxis to prevent joint bleeding in hemophilia
Describe management of acute hemarthrosis in patients with hemophilia

Disclosures

Author(s)

Mindy L. Simpson, MD

Department of Pediatrics, Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago, Illinois

Disclosures

Disclosure: Mindy L. Simpson, MD, has disclosed no relevant financial relationships.

Leonard A. Valentino, MD

Department of Pediatrics, Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago, Illinois

Disclosures

Disclosure: Leonard A. Valentino, MD, has disclosed no relevant financial relationships.

Editor

Elisa Manzotti

Publisher, Future Science Group, London, United Kingdom

Disclosures

Disclosure: Elisa Manzotti has disclosed no relevant financial relationships.

CME Author(s)

Laurie Barclay, MD

Freelance writer and reviewer, Medscape, LLC

Disclosures

Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

CME Reviewer(s)

Nafeez Zawahir, MD

CME Clinical Director, Medscape, LLC

Disclosures

Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

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Expert Commentary

The management of joint bleeding in hemophilia has evolved from reactive therapy initiated after the onset of bleeding symptoms to prophylaxis to prevent hemarthroses and the subsequent arthropathy,^[28] Despite the effectiveness of prophylaxis,^[37,40] there are significant barriers to its widespread implementation, in particular the need for frequent dosing/frequent venous access, which can result in poor adherence,^[49,92] and the high cost of factor concentrate. New drugs and drug delivery systems currently in development may overcome some of these obstacles.^[93] For example, the development of FVIII and FIX concentrates with an extended duration of action will reduce the frequency of intravenous injections, and oral agents will obviate the need for venous access all together. Ultimately, correction of the gene defect will cure hemophilia, although such therapy remains on the distant horizon.^[94] Until that time, patients will continue to experience joint bleeding and will require appropriate interventions, including replacement of the deficient clotting factor, analgesia and physiotherapy.

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Page 8 of 10

Five-year View

CME Information

Abstract and Introduction
FVIII & FIX Genetics
Evolution of Hemophilia Therapy
Mechanisms of Blood-induced Joint Disease
Rationale for Prophylaxis
Management of Acute Hemarthrosis
Outcome Measurement
Expert Commentary
Five-year View
Key Issues

References

CME

Management of Joint Bleeding in Hemophilia

Target Audience and Goal Statement

Disclosures

Author(s)

Mindy L. Simpson, MD

Leonard A. Valentino, MD

Editor

Elisa Manzotti

CME Author(s)

Laurie Barclay, MD

CME Reviewer(s)

Nafeez Zawahir, MD

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Management of Joint Bleeding in Hemophilia: Expert Commentary

Expert Commentary

Table of Contents

References

Faculty and Disclosures

Author(s)

Mindy L. Simpson, MD

Leonard A. Valentino, MD

Editor

Elisa Manzotti

CME Author(s)

Laurie Barclay, MD

CME Reviewer(s)

Nafeez Zawahir, MD

CME

Management of Joint Bleeding in Hemophilia

Target Audience and Goal Statement

Disclosures

Author(s)

Mindy L. Simpson, MD

Leonard A. Valentino, MD

Editor

Elisa Manzotti

CME Author(s)

Laurie Barclay, MD

CME Reviewer(s)

Nafeez Zawahir, MD

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Management of Joint Bleeding in Hemophilia: Expert Commentary

Expert Commentary

Table of Contents