OBJECTIVES: Hemophilia causes substantial clinical burden, which can lead to reduced health-related quality of life (HRQOL) in patients. This systematic literature review aimed to examine the humanistic burden of hemophilia A or B, with or without inhibitors in patients ≥ 12 years and their caregivers.
METHODS: Searches were conducted in Embase, MEDLINE, and MEDLINE In-Process for English-language articles published from November 2012 through November 2022. Abstracts and full texts were screened by one researcher with a 10% quality check by another researcher.
RESULTS: Screening 6,057 citations yielded 42 observational studies for inclusion. The studies were heterogenous, utilizing 25 different HRQOL scales. Patients with hemophilia A or B experienced poor HRQOL. Severe disease and inhibitor status had a negative impact on HRQOL. For example, the mean predicted EQ-5D-5L score for patients with hemophilia A or B without inhibitors was 13% worse for patients with severe versus mild disease (−0.105). Globally, patients with hemophilia A or B with inhibitors had worse mean EQ-5D scores (0.7075) than those without inhibitors (hemophilia A, 0.7453; hemophilia B, 0.7407). Severe hemophilia A had a negative impact on work productivity. Hemophilia A or B had minimal to moderate negative effect on functional abilities, with mean Hemophilia Activities List scores ranging from 60 to 99. Caregivers of children with hemophilia A or B with inhibitors had significantly poorer HRQOL compared with those providing care to children without inhibitors based on the care-related HRQOL instrument and a novel disease-specific questionnaire. Decreased infusion frequency appeared to reduce the practical burden and emotional distress of caregiving.
CONCLUSIONS: Patients with hemophilia A or B and their caregivers experience poor HRQOL and functionality, especially those with inhibitors, and severe disease negatively affected HRQOL.
Khanji C, Nuabor W, Kim HK, Yubin SA, Kim R, Njue A. Systematic literature review of the humanistic burden of hemophilia A and B. Poster presented at the ISPOR Europe 2024; November 17, 2024. Barcelona, Spain. [abstract] Value Health. 2024 Dec; 27(12 Supplement):S613. doi: 10.1016/j.jval.2024.10.3082
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