Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Comorbidity and Mortality in Men and Women With Haemophilia in Three Nordic Countries–Comparisons to Matched Controls

Steen Carlsson, Katarina LU orcid ; Astermark, Jan LU ; Baghaei, Fariba ; Brodin, Elisabeth ; Funding, Eva ; Holmström, Margareta ; Österholm, Klaus ; Bergenstråle, Sofia and Lethagen, Stefan (2025) In Haemophilia 31(3). p.401-411
Abstract

Introduction: Comorbidities and public health conditions in haemophilia are receiving increasing attention. Aim: To analyse the prevalence of comorbidities and mortality in people with haemophilia (PwH) compared to matched controls in subgroups (factor consumption and sex). Methods: This study used longitudinal individual-level data (11 years) from national registers in three Nordic countries (Denmark, Finland and Sweden) from the MIND study (NCT03276130) for PwH and matched controls (1:5 on birth year and sex). It compared the prevalence of arthropathy, human immunodeficiency virus (HIV), hepatitis, depression, anxiety, hypertension, ischaemic heart disease, atrial fibrillation, stroke, diabetes, cancer, kidney disease and epilepsy,... (More)

Introduction: Comorbidities and public health conditions in haemophilia are receiving increasing attention. Aim: To analyse the prevalence of comorbidities and mortality in people with haemophilia (PwH) compared to matched controls in subgroups (factor consumption and sex). Methods: This study used longitudinal individual-level data (11 years) from national registers in three Nordic countries (Denmark, Finland and Sweden) from the MIND study (NCT03276130) for PwH and matched controls (1:5 on birth year and sex). It compared the prevalence of arthropathy, human immunodeficiency virus (HIV), hepatitis, depression, anxiety, hypertension, ischaemic heart disease, atrial fibrillation, stroke, diabetes, cancer, kidney disease and epilepsy, and mortality. Three severity subgroups for PwH were identified by use of factor concentrates and sex, including female carriers. Results: Data for 2716 PwH (24,921 person-years) were analysed. PwH had increased prevalence of single and multiple comorbidities (p < 0.001), and increased mortality (p < 0.001). Arthropathy was more prevalent in all male PwH subgroups in Nordic countries, and among women including carriers in Sweden (odds ratios: ∼2→12). Arthropathy was a concomitant comorbidity alongside depression, hypertension, cardiovascular conditions, diabetes, hepatitis and HIV. Hypertension was more prevalent for PwH than controls in most subgroups. Hepatitis and HIV had the highest odds ratios among PwH in Denmark and Sweden. Conclusion: Arthropathy occurs in combination with a complex of comorbidities. The potential common pathophysiologic denominator should be further explored. Higher prevalence of comorbidities and mortality rates in men and women with haemophilia call for a holistic approach with more ambitious treatment goals for PwH across severities and sexes. Trial Registration: The MIND Study was registered at ClinicalTrials.gov: NCT03276130.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
arthropathy, case-control studies, comorbidity, haemophilia A, haemophilia B, hypertension, mortality
in
Haemophilia
volume
31
issue
3
pages
11 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:105000465649
  • pmid:40099856
ISSN
1351-8216
DOI
10.1111/hae.70023
language
English
LU publication?
yes
id
cd720a15-eccd-490f-b905-2cf307c6c297
date added to LUP
2025-09-12 10:16:56
date last changed
2025-10-14 10:07:26
@article{cd720a15-eccd-490f-b905-2cf307c6c297,
  abstract     = {{<p>Introduction: Comorbidities and public health conditions in haemophilia are receiving increasing attention. Aim: To analyse the prevalence of comorbidities and mortality in people with haemophilia (PwH) compared to matched controls in subgroups (factor consumption and sex). Methods: This study used longitudinal individual-level data (11 years) from national registers in three Nordic countries (Denmark, Finland and Sweden) from the MIND study (NCT03276130) for PwH and matched controls (1:5 on birth year and sex). It compared the prevalence of arthropathy, human immunodeficiency virus (HIV), hepatitis, depression, anxiety, hypertension, ischaemic heart disease, atrial fibrillation, stroke, diabetes, cancer, kidney disease and epilepsy, and mortality. Three severity subgroups for PwH were identified by use of factor concentrates and sex, including female carriers. Results: Data for 2716 PwH (24,921 person-years) were analysed. PwH had increased prevalence of single and multiple comorbidities (p &lt; 0.001), and increased mortality (p &lt; 0.001). Arthropathy was more prevalent in all male PwH subgroups in Nordic countries, and among women including carriers in Sweden (odds ratios: ∼2→12). Arthropathy was a concomitant comorbidity alongside depression, hypertension, cardiovascular conditions, diabetes, hepatitis and HIV. Hypertension was more prevalent for PwH than controls in most subgroups. Hepatitis and HIV had the highest odds ratios among PwH in Denmark and Sweden. Conclusion: Arthropathy occurs in combination with a complex of comorbidities. The potential common pathophysiologic denominator should be further explored. Higher prevalence of comorbidities and mortality rates in men and women with haemophilia call for a holistic approach with more ambitious treatment goals for PwH across severities and sexes. Trial Registration: The MIND Study was registered at ClinicalTrials.gov: NCT03276130.</p>}},
  author       = {{Steen Carlsson, Katarina and Astermark, Jan and Baghaei, Fariba and Brodin, Elisabeth and Funding, Eva and Holmström, Margareta and Österholm, Klaus and Bergenstråle, Sofia and Lethagen, Stefan}},
  issn         = {{1351-8216}},
  keywords     = {{arthropathy; case-control studies; comorbidity; haemophilia A; haemophilia B; hypertension; mortality}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{401--411}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Haemophilia}},
  title        = {{Comorbidity and Mortality in Men and Women With Haemophilia in Three Nordic Countries–Comparisons to Matched Controls}},
  url          = {{http://dx.doi.org/10.1111/hae.70023}},
  doi          = {{10.1111/hae.70023}},
  volume       = {{31}},
  year         = {{2025}},
}