{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T18:43:50Z","timestamp":1761677030894,"version":"3.40.5"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T00:00:00Z","timestamp":1636502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Von Willebrand disease (VWD) is the most common inherited bleeding disorder. The bleeding phenotype is variable, and some individuals have persistent symptoms post\u2010diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To characterize bleeding patterns in patients with VWD before and after diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>De\u2010identified claims data for commercially insured patients in the IQVIA PharMetrics\u00ae Plus US database (Jan\u20102006 to Jun\u20102015) were extracted. Eligible patients had \u22652 claims for VWD (ICD\u20109 code 286.4), and continuous health\u2010plan enrolment for \u22652 years before and after diagnosis. Bleeding event, treatment and treating\u2010physician type were analysed for 18 months before and 7\u201024 months after diagnosis, according to pre\u2010diagnosis bleeding phenotype (claims from one vs multiple bleed sites) and post\u2010diagnosis bleeding status (resolved [no post\u2010diagnosis bleed claims] vs continued [\u22651 claim]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data for 3756 eligible patients (72.6% female; 71.0% aged \u226518 years at diagnosis) were analysed. Overall, 642 (17.1%) and 805 (21.4%) patients had single\u2010 and multiple\u2010site bleed claims pre\u2010diagnosis, respectively, and 1263 (33.6%) patients (38.5% of women, 20.8% of men) continued to bleed post\u2010diagnosis. Multiple\u2010site bleeding was associated with pre\u2010diagnosis heavy menstrual bleeding (HMB), oral contraceptive (OC) use and nasal cauterization. Continued bleeding post\u2010diagnosis was associated with pre\u2010diagnosis gastrointestinal bleeding, HMB and epistaxis; pre\u2010diagnosis use of OCs, aminocaproic acid and nasal cauterization; and younger age at diagnosis. Few patients consulted a haematologist for bleed management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Many patients with VWD have persistent bleeding from multiple sites and continue to bleed post\u2010diagnosis. Our findings suggest a need to optimize management to reduce the symptomatic burden of VWD following diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.14448","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T03:40:54Z","timestamp":1636602054000},"page":"97-108","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Bleeding patterns in patients before and after diagnosis of von Willebrand disease: Analysis of a US medical claims database"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9415-9543","authenticated-orcid":false,"given":"Jonathan C.","family":"Roberts","sequence":"first","affiliation":[{"name":"Bleeding &amp; Clotting Disorders Institute  Peoria Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9173-7179","authenticated-orcid":false,"given":"Lynn M.","family":"Malec","sequence":"additional","affiliation":[{"name":"Versiti Blood Center of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imrran","family":"Halari","sequence":"additional","affiliation":[{"name":"Charles River Associates  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5227-0673","authenticated-orcid":false,"given":"Sarah A.","family":"Hale","sequence":"additional","affiliation":[{"name":"Baxalta US Inc., a Takeda company  Cambridge Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abiola","family":"Oladapo","sequence":"additional","affiliation":[{"name":"Baxalta US Inc., a Takeda company  Cambridge Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9509-9415","authenticated-orcid":false,"suffix":"Jr","given":"Robert F.","family":"Sidonio","sequence":"additional","affiliation":[{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,11,10]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_10_2_1","DOI":"10.1182\/hematology.2019000064"},{"doi-asserted-by":"publisher","key":"e_1_2_10_3_1","DOI":"10.1007\/s40265-017-0793-2"},{"doi-asserted-by":"publisher","key":"e_1_2_10_4_1","DOI":"10.1182\/blood-2014-08-528398"},{"doi-asserted-by":"publisher","key":"e_1_2_10_5_1","DOI":"10.1111\/j.1538-7836.2009.03661.x"},{"key":"e_1_2_10_6_1","first-page":"371","article-title":"Current challenges in the diagnosis and management of patients with inherited von Willebrand's disease in Italy: an Expert Meeting Report on the diagnosis and surgical and secondary long\u2010term prophylaxis","volume":"16","author":"Schinco P","year":"2018","journal-title":"Blood Transfus"},{"doi-asserted-by":"publisher","key":"e_1_2_10_7_1","DOI":"10.1111\/jth.14886"},{"doi-asserted-by":"publisher","key":"e_1_2_10_8_1","DOI":"10.1111\/j.1538-7836.2012.04661.x"},{"doi-asserted-by":"publisher","key":"e_1_2_10_9_1","DOI":"10.1111\/j.1365-2516.2007.01643.x"},{"doi-asserted-by":"publisher","key":"e_1_2_10_10_1","DOI":"10.1111\/hae.12836"},{"unstructured":"The Lewin Group for the National Hemophilia Foundation.Strategic Summit on Von Willebrand Disease.https:\/\/www.hemophilia.org\/sites\/default\/files\/document\/files\/NHF-Strategic-Summit-Report-on-von-Willebrand-disease_1.pdf. 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