[A cohort study on cardiovascular diseases in adults with hemophilia: an interim subanalysis on comorbidities and medication from ADVANCE Japan].

INTRODUCTION

As life expectancy in hemophilia improves, chronic comorbidities and treatment-related challenges demand greater attention.

OBJECTIVE

To characterize comorbidities, medication use, and cardiovascular risk factors in Japanese adults (≥40 years) with hemophilia enrolled in a prospective, multicenter cohort study (ADVANCE Japan cohort).

METHODS

A subanalysis was conducted in participants who completed at least one follow-up visit between 2019 and 2023.

RESULTS

Seventeen of the 599 participants died (2.8%), mainly from liver disease, intracranial hemorrhage, and malignancy. Thirty-two cancers were documented, with hepatocellular carcinoma being the most common. Compared with the general male population, hypertension was more common in the hemophilia cohort (OR 1.51, 95%CI: 1.17-1.93), whereas dyslipidemia (OR 0.48, 95%CI: 0.37-0.62), chronic kidney disease (OR 0.53, 95%CI: 0.38-0.76), obesity (OR 0.50, 95%CI: 0.40-0.64), and smoking (OR 0.74, 95%CI: 0.59-0.93) were less common. Non-steroidal anti-inflammatory drugs were frequently prescribed despite guideline recommendations, reflecting likely chronic pain from advanced hemophilic arthropathy. Four patients developed new factor VIII/IX inhibitors, including two without prior history.

CONCLUSION

This interim analysis reveals distinctive patterns of comorbidity, medication use, and cardiovascular risk among aging Japanese adults with hemophilia, underscoring the need for tailored long-term care strategies.