Comparisons of global coagulation potential and bleeding episodes in emicizumab-treated hemophilia A patients and mild hemophilia A patients View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2022-01-19

AUTHORS

Yuto Nakajima, Kuniyoshi Mizumachi, Naruto Shimonishi, Shoko Furukawa, Koji Yada, Kenichi Ogiwara, Masahiro Takeyama, Midori Shima, Keiji Nogami

ABSTRACT

Emicizumab reduces bleeding events in patients with severe hemophilia A (HA). The coagulation potential of emicizumab at a clinical dose appears to correspond to about 15 IU/dL of factor VIII activity (FVIII:C), the equivalent of converting from a severe to mild phenotype. However, the clinical and laboratory characteristics of HA patients receiving emicizumab (Emi-PwHA) compared with patients with mild HA (PwMHA) remain to be determined. We reviewed clinical data from Emi-PwHA (n = 63) and PwMHA (n = 15) and evaluated comprehensive coagulation function using Ca2+-triggered rotational thromboelastometry (ROTEM) and ellagic acid/tissue factor-triggered clot waveform analysis (modified CWA). The median FVIII:C in PwMHA was 13.0 (IQR 8.5–17.0) IU/dL. Bleeding patterns in both groups were similar and classified into three categories: (1) spontaneous bleeding, post-traumatic, (2) bleeding within 1–2 days, and (3) delayed bleeding after 1–2 weeks. The coagulation potential in Emi-PwHA with and without breakthrough bleeds was comparable. Furthermore, coagulation function in Emi-PwHA was equivalent to PwMHA, although time between treatment and hospitalization for breakthrough bleeds in PwMHA appeared to be longer than those in Emi-PwHA. The coagulation potential and bleeding patterns appeared to be similar in Emi-PwHA and PwMHA, indicating that emicizumab-driven coagulation potential reflected mild HA. More... »

PAGES

489-498

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12185-021-03276-7

DOI

http://dx.doi.org/10.1007/s12185-021-03276-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1144755544

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35043383


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