[A cohort study on cardiovascular diseases in adults with hemophilia: an interim subanalysis on comorbidities and medication from ADVANCE Japan].

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INTRODUCTION: As life expectancy in hemophilia improves, chronic comorbidities and treatment-related challenges demand greater attention. OBJECTIVE: To characterize comorbidities, medication use, and cardiovascular risk factors in Japanese adults (≥40 years) with hemophilia enrolled in a prospective, multicenter cohort study (ADVANCE Japan cohort). METHODS: A subanalysis was conducted in participants who completed at least one follow-up visit between 2019 and 2023. RESULTS: Seventeen of the 599 participants died (2.8%), mainly from liver disease, intracranial hemorrhage, and malignancy. Thirty-two cancers were documented, with hepatocellular carcinoma being the most common. Compared with the general male population, hypertension was more common in the hemophilia cohort (OR 1.51, 95%CI: 1.17-1.93), whereas dyslipidemia (OR 0.48, 95%CI: 0.37-0.62), chronic kidney disease (OR 0.53, 95%CI: 0.38-0.76), obesity (OR 0.50, 95%CI: 0.40-0.64), and smoking (OR 0.74, 95%CI: 0.59-0.93) were less common. Non-steroidal anti-inflammatory drugs were frequently prescribed despite guideline recommendations, reflecting likely chronic pain from advanced hemophilic arthropathy. Four patients developed new factor VIII/IX inhibitors, including two without prior history. CONCLUSION: This interim analysis reveals distinctive patterns of comorbidity, medication use, and cardiovascular risk among aging Japanese adults with hemophilia, underscoring the need for tailored long-term care strategies.

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