Bone Health Screenings Underused in US Hemophilia Centers Despite High Risk
Despite mounting evidence linking bleeding disorders to poor bone health, a new study reveals that routine bone density screenings using dual-energy x-ray absorptiometry (DEXA) scans remain uncommon at hemophilia treatment centers (HTCs) across the US. Published in Haemophilia, the study surveyed 147 federally funded HTCs, with only 66 centers (45%) responding.
“Rates of screening for osteoporosis were suboptimal,” researchers noted. Of those who responded to the survey, only 13.6% reported regularly performing DEXA scans to measure bone mineral density and detect osteoporosis.
The findings are particularly concerning given the well-documented bone health risks in people with hemophilia and von Willebrand disease (VWD). Both conditions involve impaired blood clotting, and in severe hemophilia, recurrent joint bleeds can further compromise bone strength. Studies have also shown elevated rates of osteoporosis and fractures in patients with VWD.
Vitamin D screenings fared slightly better, with about one-third of centers performing them during annual visits. DEXA scans were most often initiated for patients with severe hemophilia, especially when additional risk factors were present, such as HIV infection, low mobility, or previous fractures.
The authors urge further research to understand the barriers to consistent screening and call for national guidelines on bone health assessments in people with bleeding disorders. As the population of patients ages, proactive management of bone health is increasingly critical.
Reference
Lobo A. Hemophilia patients’ bone health screening rates low at US HTCs. Hemophilia News Today. April 1, 2025. Accessed April 17, 2025. https://hemophilianewstoday.com/news/hemophilia-patients-bone-health-screening-rates-low-us-htcs/
