Abstract

Background: Hemophilic arthropathy is the most common chronic complication in individuals with hemophilia, leading to significant joint damage and reduced quality of life. It shares inflammatory characteristics with rheumatoid arthritis (RA), prompting interest in biomarkers like soluble vascular cell adhesion molecule-1 (sVCAM-1), which is known to be elevated in RA and other inflammatory conditions. This study aimed to explore the clinical relevance of sVCAM-1 as a potential biomarker in hemophilic arthropathy. Aims: To estimate plasma levels of sVCAM-1 in hemophilia patients compared to healthy controls. To compare sVCAM-1 levels between hemophilia patients with and without arthropathy. To correlate sVCAM-1 levels with clinical and hematological parameters. Methods: A cross-sectional study was conducted in Baghdad (Jan–Dec 2024) including 80 male patients with hemophilia (70 with hemophilia A, 10 with hemophilia B), divided equally into arthropathy and non-arthropathy groups, and 16 age- and sex-matched healthy controls. Plasma sVCAM-1 levels were measured using ELISA, and clinical data including factor levels, HJHS scores, and hematologic markers were collected. Results: Arthropathy was found in 50% of hemophilia patients, most commonly affecting the ankle. Severe disease was more frequent in hemophilia A. sVCAM-1 levels were significantly higher in patients with arthropathy (4.0 µg/mL) compared to those without (2.1 µg/mL) and controls (0.69 µg/mL). sVCAM-1 showed strong positive correlation with ESR (r=0.283, p=0.01) and HJHS score (r=0.9, p=0.001), but not with WBC, hemoglobin, or platelet count. Diagnostic accuracy for sVCAM-1 was excellent (AUC=1.0, p<0.001). Conclusions: sVCAM-1 is significantly elevated in hemophilia patients, especially those with arthropathy, and correlates with inflammatory activity and joint damage, supporting its potential as a clinical biomarker