{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:51:08Z","timestamp":1787014268292,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"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":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>For people with haemophilia A (PwHA), bleeding in the joints leads to joint damage and haemophilia\u2010related arthropathy, impacting range of motion and life expectancy. Existing guidelines for managing haemophilia A support healthcare professionals (HCPs) and PwHA in their efforts to preserve joint health. However, such guidance should be reviewed, considering emerging evidence and consensus as presented in this manuscript.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifteen HCPs experienced in the management of PwHA in the UK participated in a three\u2010round Delphi panel. Consensus was defined at \u226570% of panellists agreeing or disagreeing for Likert\u2010scale questions, and \u226570% selecting the same option for multiple\u2010 or single\u2010choice questions. Questions not reaching consensus were revised for the next round.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>26.8% (11\/41), 44.8% (13\/29) and 93.3% (14\/15) of statements reached consensus in Rounds 1, 2 and 3, respectively. HCPs agreed that prophylaxis should be offered to patients with a baseline factor VIII (FVIII) level of \u22645 IU\/dL and that, where there is no treatment burden, the aim of prophylaxis should be to achieve a trough FVIII level \u226515 IU\/dL and maintain a longer period with FVIII levels of \u226520\u201330 IU\/dL to provide better bleed protection. The aspirational goal for PwHA is to prevent all joint bleeds, which may be achieved by maintaining normalised (50\u2013150 IU\/dL) FVIII levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The panel of experts were largely aligned on approaches to preserving joint health in PwHA, and this consensus may help guide HCPs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.14934","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T03:28:27Z","timestamp":1705634907000},"page":"306-319","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Expert United Kingdom consensus on the preservation of joint health in people with moderate and severe haemophilia A: A modified Delphi panel"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8268-3268","authenticated-orcid":false,"given":"Mike","family":"Laffan","sequence":"first","affiliation":[{"name":"Centre for Haematology Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5962-7647","authenticated-orcid":false,"given":"Paul","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"Katharine Dormandy Haemophilia Centre and Thrombosis Unit Royal Free London NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayashree","family":"Motwani","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology Birmingham Children's Hospital  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayanthi","family":"Alamelu","sequence":"additional","affiliation":[{"name":"Paediatric Haematology Evelina London Children's Hospital Guy's and St Thomas\u2019 NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Austin","sequence":"additional","affiliation":[{"name":"Department of Haematology St George's University Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Classey","sequence":"additional","affiliation":[{"name":"Centre for Haemostasis and Thrombosis Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"Dolan","sequence":"additional","affiliation":[{"name":"Centre for Haemostasis and Thrombosis Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Eales","sequence":"additional","affiliation":[{"name":"The Children's Team at Oxford Haemophilia and Thrombosis Comprehensive Care Centre Oxford University Hospitals NHS Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Gooding","sequence":"additional","affiliation":[{"name":"Haematology Department Belfast Health and Social Care Trust  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Grainger","sequence":"additional","affiliation":[{"name":"Paediatric Haematology Royal Manchester Children's Hospital  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9336-5249","authenticated-orcid":false,"given":"Catherine","family":"Harrison","sequence":"additional","affiliation":[{"name":"Sheffield Haemophilia &amp; Thrombosis Centre Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April","family":"Jones","sequence":"additional","affiliation":[{"name":"Newcastle Haemophilia Centre Newcastle Upon Tyne Hospitals NHS Foundation Trust  Newcastle Upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Haemophilia Comprehensive Care Centre Great Ormond Street Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Oyesiku","sequence":"additional","affiliation":[{"name":"Southern Haemophilia Network Basingstoke and North Hampshire Hospital Hampshire Hospitals NHS Foundation Trust  Basingstoke Hampshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Rodgers","sequence":"additional","affiliation":[{"name":"Department of Haematology Glasgow Royal Infirmary  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6175-3343","authenticated-orcid":false,"given":"David","family":"Stephensen","sequence":"additional","affiliation":[{"name":"Kent Haemophilia Centre Kent and Canterbury Hospital  Canterbury Kent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Talks","sequence":"additional","affiliation":[{"name":"Newcastle Haemophilia Centre Newcastle Upon Tyne Hospitals NHS Foundation Trust  Newcastle Upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaneil","family":"Sonecha","sequence":"additional","affiliation":[{"name":"Swedish Orphan Biovitrum Ltd  Great Abington UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Danquah","sequence":"additional","affiliation":[{"name":"Swedish Orphan Biovitrum Ltd  Great Abington UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"issue":"6","key":"e_1_2_11_2_1","first-page":"535","article-title":"Diagnosis and care of patients with mild haemophilia: practical recommendations for clinical management","volume":"16","author":"Benson G","year":"2018","journal-title":"Blood Transfus"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14046"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1586\/ehm.12.27"},{"key":"e_1_2_11_5_1","unstructured":"World Federation of Hemophilia.Chronic hemophilic synovitis: the role of radiosynovectomy 2004.https:\/\/www1.wfh.org\/publication\/files\/pdf\u20101176.pdf"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14734"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.15256\/joc.2011.1.2"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2021.2018053"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13862"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S304597"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067659"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13616"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14201"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16704"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH14-05-0407"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-01-528414"},{"issue":"1","key":"e_1_2_11_17_1","first-page":"1","article-title":"The Delphi technique: making sense of consensus","volume":"12","author":"Hsu C\u2010C","year":"2007","journal-title":"Pract Assess Res Eval"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216317690685"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02539.x"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020005673"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12905"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2020-140306"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12195"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2003.00870.x"},{"key":"e_1_2_11_25_1","unstructured":"United Kingdom Haemophilia Centre Doctors' Organisation.UKHCDO Annual Report 2022.http:\/\/www.ukhcdo.org\/wp\u2010content\/uploads\/2022\/12\/UKHCDO\u2010Annual\u2010Report\u20102022\u20102021\u201022\u2010Data.pdf"}],"container-title":["Haemophilia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.14934","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T22:06:39Z","timestamp":1714428399000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hae.14934"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,19]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1111\/hae.14934"],"URL":"https:\/\/doi.org\/10.1111\/hae.14934","archive":["Portico"],"relation":{},"ISSN":["1351-8216","1365-2516"],"issn-type":[{"value":"1351-8216","type":"print"},{"value":"1365-2516","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,19]]},"assertion":[{"value":"2023-11-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}