Does intense prophylaxis always lead to the
desired outcomes?
Despite the plethora of data showing the
advantages of standard rFVIII and rFIX therapies,
prophylaxis with these products may delay versus
prevent the onset of joint disease. A German
study followed up 49 patients with haemophilia A
for 28 years and revealed that they developed
joint disease despite intensive prophylactic
treatment, most prominently located in the
ankles. Moreover, this linear pathological process
only became apparent approximately ten years
after treatment initiation. 25
A cross-sectional study using magnetic
resonance imaging to evaluate joint status in
patients with severe haemophilia A, a