Work

Use of the Multidimensional Haemophilia Pain Questionnaire (MHPQ) in Patients With Severe Haemophilia A Treated With Emicizumab: A Pilot Cross‐Sectional, Single‐Centre Study

Year: 2026

Type: article

Abstract: BACKGROUND: Despite effective bleed prevention with Emicizumab, pain remains a relevant clinical burden in adults with severe haemophilia A (sHA). A multidimensional assessment is needed to better characterize contemporary haemophilia-related pain. OBJECTIVE: To evaluate the prevalence, characteristics, and functional impact of pain in adults with sHA receiving Emicizumab prophylaxis using the Multidimensional Haemophilia Pain Questionnaire (MHPQ). METHODS: In this single-centre, cross-sectional pilot study, 27 adults with sHA on Emicizumab prophylaxis completed the MHPQ. Pain localization, frequency, triggering factors, intensity, and interference across life domains were assessed descriptively. RESULTS: Lifetime haemophilia-related pain was reported by 85.2% of participants, and 77.8% experienced pain within the previous 12 months. Pain most frequently involved ankles (52.4%), knees (52.4%), and elbows (28.6%). All patients with recent pain reported pain during bleeding episodes; however, movement-related triggers, including accidental movements (66.7%) and physical activity (54.2%), were also common. Pain intensity was generally mild-to-moderate, with the highest median scores observed after accidental movements (median 4, IQR 2-6). Pain interfered predominantly with general activity (71.4%), walking ability (66.7%), mood (61.9%), and enjoyment of life (61.9%). Arthropathy was documented in 70.4% of patients. CONCLUSIONS: In the non-factor prophylaxis era, pain remains prevalent and functionally relevant in adults with sHA despite effective bleed control. These findings suggest that haemophilia-related pain is not exclusively bleeding-driven and highlight the importance of structured, multidimensional pain assessment in routine haemophilia care.

Source: Haemophilia

DOI: 10.1111/hae.70318