Chromogenic Factor VIII Assay for Patients with Hemophilia A and on Emicizumab Therapy

Yacoub, Olivia; Duncan, Elizabeth M.

doi:10.1007/978-1-0716-3175-1_39

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…Therefore, anti-idiotype monoclonal antibodies for emicizumab have been established, and it has been deemed possible to measure FVIII activity and inhibitor titers using this antibody in the presence of emicizumab [10]. Furthermore, the new chromogenic substrate assay is not affected by emicizumab and is suitable for determining FVIII coagulant activity and inhibitors [11].…”

Section: Introductionmentioning

confidence: 99%

The Evaluation of Clot Waveform Analyses for Assessing Hypercoagulability in Patients Treated with Factor VIII Concentrate

Matsumoto,

Wada,

Shiraki

et al. 2023

JCM

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Background: Regular prophylactic therapy has become an increasingly common treatment for severe hemophilia. Therefore, hypercoagulability—a potential risk factor of thrombosis—is a cause for concern in hemophilic patients treated with a high dose of FVIII concentrate. In clot waveform analysis (CWA)-thrombin time (TT), a small amount of thrombin activates clotting factor VIII (FVIII) instead of fibrinogen, resulting in FVIII measurements using CWA-TT with a small amount of thrombin. Methods: The coagulation ability of patients treated with FVIII concentrate or emicizumab was evaluated using activated partial thromboplastin time (APTT), TT and a small amount of tissue factor-induced FIX activation assay (sTF/FIXa) using CWA. Results: The FVIII activity based on CWA-TT was significantly greater than that based on the CWA-APTT or chromogenic assay. FVIII or FVIII-like activities based on the three assays in plasma without emicizumab were closely correlated; those in plasma with emicizumab based on CWA-TT and chromogenic assays were also closely correlated. CWA-APTT and CWA-TT showed different patterns in patients treated with FVIII concentrates compared to those treated with emicizumab. In particular, CWA-TT in patients treated with FVIII concentrate showed markedly higher peaks in platelet-rich plasma than in platelet-poor plasma. CWA-APTT showed lower coagulability in hemophilic patients treated with FVIII concentrate than in healthy volunteers, whereas CWA-sTF/FIXa did not. In contrast, CWA-TT showed hypercoagulability in hemophilic patients treated with FVIII concentrate. Conclusions: CWA-TT can be used to evaluate the thrombin bursts that cause hypercoagulability in patients treated with emicizumab. Although routine APTT evaluations demonstrated low coagulation ability in patients treated with FVIII concentrate, CWA-TT showed hypercoagulability in these patients, suggesting that the evaluation of coagulation ability may be useful when using multiple assays.

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Section: Introductionmentioning

confidence: 99%

The Evaluation of Clot Waveform Analyses for Assessing Hypercoagulability in Patients Treated with Factor VIII Concentrate

Matsumoto,

Wada,

Shiraki

et al. 2023

JCM

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Innovative Diagnostic Solutions in Hemostasis

Favaloro,

Pasalic

2024

Diagnostics

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Hemostasis describes the process of blood clotting homeostasis. Hemostasis reflects a balance of procoagulant and anticoagulant mechanisms that aim to prevent both bleeding and thrombosis. If hemostasis is disrupted, and bleeding or thrombosis occur, then laboratory testing may ensue to either diagnose the reason for bleeding or thrombosis, or to manage patients under therapy or treatment for bleeding or thrombosis. A wide range of tests of hemostasis are available to laboratories and to clinicians, from routine coagulation assays to specialized hemostasis assays and platelet function. In the current narrative review, we highlight some of the history of innovative diagnostic solutions, such as the integration of chemiluminescence and flow cytometry in the hemostasis diagnostic armamentarium, as well as providing a glimpse to the possible future of diagnostic hemostasis testing. Future directions include the potential for artificial intelligence in diagnostics, the development of more global test systems that can assess both primary and secondary hemostasis, and several innovations to enable the ongoing evolution of therapies to rebalance hemostasis and requiring precise monitoring. This review underscores the ongoing need for innovation to enhance the diagnostic landscape of hemostasis, ensuring better patient outcomes through more accurate and efficient diagnostic methods.

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Chromogenic Factor VIII Assay for Patients with Hemophilia A and on Emicizumab Therapy

Cited by 2 publications

References 26 publications

The Evaluation of Clot Waveform Analyses for Assessing Hypercoagulability in Patients Treated with Factor VIII Concentrate

The Evaluation of Clot Waveform Analyses for Assessing Hypercoagulability in Patients Treated with Factor VIII Concentrate

Innovative Diagnostic Solutions in Hemostasis

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