Hemophilia is an inherited bleeding disorder characterized by deficiency of clotting factors, leading to increased bleeding tendencies. The most common complications are joint bleeds (hemarthroses), which cause chronic changes in joints and ultimately disability. Recurrent hemarthroses often result from chronic synovitis in target joints of patients with hemophilia, a process driven by Vascular Endothelial Growth Factor (VEGF) mediated pathological angiogenesis. Intra-articular administration of Bevacizumab, a VEGF neutralizing monoclonal antibody, may block this process and reduce the frequency of recurrent joint bleeds. This study evaluates the efficacy and safety of intra-articular Bevacizumab for preventing recurrent hemarthrosis in patients with hemophilia and chronic synovitis.
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Annualized Bleeding Rate (ABR) of the Target Joint
Timeframe: Baseline (3 months pre-treatment) compared to the 3-month period following the completion of the treatment protocol (i.e., 3 months after the 4th injection).
Clinical Joint Health Score
Timeframe: Baseline scores compared to scores at 1, 3, 6, and 12 months after initiation of therapy
Synovial Hypertrophy
Timeframe: Baseline MRI (before starting therapy) compared to MRI performed 6 months after completion of therapy.
Joint Effusion/Hemarthrosis
Timeframe: Baseline vs. 6 months after completion of therapy.
Synovial Inflammation Composite (Soft Tissue Subtotal)
Timeframe: Baseline vs. 6 months after completion of therapy.