Double-Blind Studies on the Use of Steroids in the Treatment of Acute Hemarthrosis in Patients with Hemophilia

Abstract

Two double-blind studies showed the clinical effectiveness of a five-day course of corticosteroid treatment of acute hemarthrosis in boys with hemophilia. When antihemophilic factor or plasma thromboplastin component was given repeatedly until return of joint function was judged complete, significantly less replacement therapy of this type was needed if corticosteroids were added to the regimen. When replacement therapy was limited to a single dose of 25 units of antihemophilic factor per kilogram 89 per cent of patients in the corticosteroid group responded favorably, whereas 34 per cent of those in the control group needed additional replacement for complete return of joint function. Immobilization and splinting were not used in the treatment of the joint. These measures tend to weaken the surrounding muscle structure and thereby increase the amount of physical therapy and time needed before ambulation and complete return of function are possible.