Differences in Major Bleeding Events Between Patients With Severe Hemophilia A and Hemophilia B: A Nationwide, Population-Based Cohort Study
There has been an ongoing debate as to whether hemophilia A (HA) is more severe than hemophilia B (HB), and there are studies supporting each side of the argument. The study aimed to investigate whether any differences in major bleeding events exist between patients with severe HA and HB. A nationwi...
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doaj-eebff6f5282042c1a9f06f9ff7419c232020-11-25T04:10:02ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232019-12-012510.1177/1076029619888023Differences in Major Bleeding Events Between Patients With Severe Hemophilia A and Hemophilia B: A Nationwide, Population-Based Cohort StudyMing-Yang Shih MD0Jiaan-Der Wang MD, PhD1Jia-De Yin MD2Yu-Tse Tsan MD, PhD3Wei-Cheng Chan MS4 Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, TaiwanThere has been an ongoing debate as to whether hemophilia A (HA) is more severe than hemophilia B (HB), and there are studies supporting each side of the argument. The study aimed to investigate whether any differences in major bleeding events exist between patients with severe HA and HB. A nationwide, population-based retrospective cohort study using the National Health Insurance Research Database was conducted. We compared 658 patients with severe HA and 137 patients with severe HB without inhibitors from 1997 to 2013, during the period when adult patients older than 18 years old were treated with the on-demand therapy since birth. There was no significant difference between patients with severe HA and HB in the rate of major bleeding events, with an adjusted relative ratio of 0.79 (95% confidence interval [CI]: 0.36-1.71, P = .548). There was also no significant difference in the incidence rate of major bleeding events between adult patients with HA and HB with the on-demand therapy, and an adjusted hazard ratio (HR) of 0.82 (95% CI: 0.65-1.02). However, patients with HA had a lower incidence rate of intracranial hemorrhage, with an adjusted HR of 0.44 (95% CI: 0.25-0.79). In addition, no significant difference in the frequency of major bleeding events requiring hospitalization between patients with HA and HB was found, P > .05. In conclusion, the study demonstrated that patients with severe HB encountered a similar rate of major bleeding events to those with severe HA.https://doi.org/10.1177/1076029619888023 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ming-Yang Shih MD Jiaan-Der Wang MD, PhD Jia-De Yin MD Yu-Tse Tsan MD, PhD Wei-Cheng Chan MS |
spellingShingle |
Ming-Yang Shih MD Jiaan-Der Wang MD, PhD Jia-De Yin MD Yu-Tse Tsan MD, PhD Wei-Cheng Chan MS Differences in Major Bleeding Events Between Patients With Severe Hemophilia A and Hemophilia B: A Nationwide, Population-Based Cohort Study Clinical and Applied Thrombosis/Hemostasis |
author_facet |
Ming-Yang Shih MD Jiaan-Der Wang MD, PhD Jia-De Yin MD Yu-Tse Tsan MD, PhD Wei-Cheng Chan MS |
author_sort |
Ming-Yang Shih MD |
title |
Differences in Major Bleeding Events Between Patients With Severe
Hemophilia A and Hemophilia B: A Nationwide, Population-Based Cohort
Study |
title_short |
Differences in Major Bleeding Events Between Patients With Severe
Hemophilia A and Hemophilia B: A Nationwide, Population-Based Cohort
Study |
title_full |
Differences in Major Bleeding Events Between Patients With Severe
Hemophilia A and Hemophilia B: A Nationwide, Population-Based Cohort
Study |
title_fullStr |
Differences in Major Bleeding Events Between Patients With Severe
Hemophilia A and Hemophilia B: A Nationwide, Population-Based Cohort
Study |
title_full_unstemmed |
Differences in Major Bleeding Events Between Patients With Severe
Hemophilia A and Hemophilia B: A Nationwide, Population-Based Cohort
Study |
title_sort |
differences in major bleeding events between patients with severe
hemophilia a and hemophilia b: a nationwide, population-based cohort
study |
publisher |
SAGE Publishing |
series |
Clinical and Applied Thrombosis/Hemostasis |
issn |
1938-2723 |
publishDate |
2019-12-01 |
description |
There has been an ongoing debate as to whether hemophilia A (HA) is more severe than hemophilia B (HB), and there are studies supporting each side of the argument. The study aimed to investigate whether any differences in major bleeding events exist between patients with severe HA and HB. A nationwide, population-based retrospective cohort study using the National Health Insurance Research Database was conducted. We compared 658 patients with severe HA and 137 patients with severe HB without inhibitors from 1997 to 2013, during the period when adult patients older than 18 years old were treated with the on-demand therapy since birth. There was no significant difference between patients with severe HA and HB in the rate of major bleeding events, with an adjusted relative ratio of 0.79 (95% confidence interval [CI]: 0.36-1.71, P = .548). There was also no significant difference in the incidence rate of major bleeding events between adult patients with HA and HB with the on-demand therapy, and an adjusted hazard ratio (HR) of 0.82 (95% CI: 0.65-1.02). However, patients with HA had a lower incidence rate of intracranial hemorrhage, with an adjusted HR of 0.44 (95% CI: 0.25-0.79). In addition, no significant difference in the frequency of major bleeding events requiring hospitalization between patients with HA and HB was found, P > .05. In conclusion, the study demonstrated that patients with severe HB encountered a similar rate of major bleeding events to those with severe HA. |
url |
https://doi.org/10.1177/1076029619888023 |
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