{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T19:14:43Z","timestamp":1785870883571,"version":"3.56.0"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>von Willebrand Disease (VWD) is the most common inherited bleeding disorder, exhibiting diverse clinical manifestations depending on subtype and severity. This study aimed to assess the distribution of VWD subtypes, evaluate the correlation between Bleeding Assessment Tool (BAT) scores and clinical symptoms, and examine treatment outcomes and quality-of-life (QoL) improvements at a Hemophilia Treatment Center (HTC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational study of 147 VWD patients. Data were collected using the World Bleeding Disorders Registry (WBDR) on demographics, subtype classification, BAT scores, bleeding symptoms, and clinical outcomes. Annual bleeding rate (ABR) was calculated to quantify bleeding frequency. Treatment response and QoL changes were evaluated after twelve months. Statistical analysis included ANOVA and Kruskal\u2013Wallis tests to assess differences in bleeding severity and disease burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 147 VWD patients (mean age 14.5\u2009\u00b1\u200910.9 years), type 3 was the most common (80.9%), followed by type 2 (12.2%) and type 1 (6.8%). Gum bleeding (80.7%) was the leading symptom, followed by heavy menstrual bleeding (63%) and hemarthrosis (35%). BAT scores (&gt;12) occurred in 93.3% of type 3 and 16.7% of type 2 patients, with type 3 showing the highest ABR (&gt;30\/year in 91.6%). Joint scores were significantly higher in type 3 versus type 1 (p\u2009=\u2009.002) and type 2 (p\u2009=\u2009.004), and mean hemoglobin was lowest in type 3 (6.2\u2005g\/dL, p\u2009=\u2009.001). Treatment varied on the types. After management, ABR decreased across all subtypes; in type 3, &gt;30 bleeds\/year reduced from 91.6% to 57.1%, with improved joint scores, hemoglobin levels, and psychological well-being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Type 3 von Willebrand disease is associated with the highest clinical burden, characterized by frequent and severe bleeding requiring intensive management. In this cohort, individualized treatment was associated with reduced bleeding frequency, improved hemoglobin levels, and better patient-reported quality of life. These findings underscore the importance of comprehensive care approaches, including attention to psychological well-being, particularly in patients with severe disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10760296261422757","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T17:54:50Z","timestamp":1770832490000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Spectrum, Subtype Distribution, and Treatment Outcomes in von Willebrand Disease: A Prospective Study from a Hemophilia Treatment Center in Pakistan"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7867-1275","authenticated-orcid":false,"given":"Munira","family":"Borhany","sequence":"first","affiliation":[{"name":"Hemophilia Welfare Society"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7508-4645","authenticated-orcid":false,"given":"Heeba","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Hemophilia Welfare Society"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nida Khurshid","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Hemophilia Welfare Society"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maleeha","family":"Umair","sequence":"additional","affiliation":[{"name":"Hemophilia Welfare Society"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raheel","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Hemophilia Welfare Society"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1076029610387125"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.4103\/MJBL.MJBL_18_20"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1597\/13-186"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13064"},{"issue":"26","key":"e_1_3_2_6_2","first-page":"4037","article-title":"The bleeding score predicts clinical outcomes and replacement therapy in adults with von Willebrand disease","volume":"123","author":"Federici AB","year":"2014","unstructured":"Federici AB, Bucciarelli P, Castaman G, et al. The bleeding score predicts clinical outcomes and replacement therapy in adults with von Willebrand disease. Blood J Am Soc Hematol. 2014;123(26):4037-4044.","journal-title":"Blood J Am Soc Hematol"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2010.03864.x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacbts.2020.08.009"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12481"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.13476"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15419"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18001"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13998"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.14266"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15444"},{"key":"e_1_3_2_16_2","unstructured":"Centers for Disease Control and Prevention. Data and Statistics on von Willebrand Disease. https:\/\/www.cdc.gov\/von-willebrand\/data\/index.htmlCDC."},{"key":"e_1_3_2_17_2","unstructured":"NHLBI NIH. The Diagnosis Evaluation and Management of von Willebrand Disease: Full Report. https:\/\/www.nhlbi.nih.gov\/health-topics\/diagnosis-evaluation-and-management-of-von-willebrand-disease\/von-willebrand-disease-full-reportNHLBI NIH."},{"key":"e_1_3_2_18_2","unstructured":"StatPearls. Von Willebrand Disease. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459222\/NCBI."},{"key":"e_1_3_2_19_2","unstructured":"ISTH-SSC Bleeding Assessment Tool. https:\/\/bleedingscore.certe.nl\/Bleeding Score."},{"key":"e_1_3_2_20_2","unstructured":"PubMed. Correlation of bleeding score with frequency and severity of bleeding symptoms in FXIII deficiency assessing by the ISTH Bleeding Assessment Tool. https:\/\/pubmed.ncbi.nlm.nih.gov\/31303509\/PubMed."},{"key":"e_1_3_2_21_2","unstructured":"European Haemophilia Consortium. Von Willebrand Disease. https:\/\/www.ehc.eu\/bleeding-disorder\/von-willebrand-disease\/European Haemophilia Consortium (EHC)."},{"key":"e_1_3_2_22_2","unstructured":"PubMed. Health-related quality of life among adult patients with moderate and severe von Willebrand disease. https:\/\/pubmed.ncbi.nlm.nih.gov\/20345712\/PubMed."},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-024-00536-8"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15247"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2019.07.010"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S325031"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.020138"}],"container-title":["Clinical and Applied Thrombosis\/Hemostasis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296261422757","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10760296261422757","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296261422757","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:05:40Z","timestamp":1777385140000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10760296261422757"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":26,"alternative-id":["10.1177\/10760296261422757"],"URL":"https:\/\/doi.org\/10.1177\/10760296261422757","relation":{},"ISSN":["1076-0296","1938-2723"],"issn-type":[{"value":"1076-0296","type":"print"},{"value":"1938-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"10760296261422757"}}