2020
DOI: 10.1055/s-0040-1710315
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Emicizumab Improves Ex Vivo Clotting Function in Patients with Mild/Moderate Hemophilia A

Abstract: Background Emicizumab prophylaxis is a promising treatment that reduces bleeding events in severely affected patients with hemophilia A (PwHA). It is anticipated that emicizumab could be similarly effective in mild/moderate PwHA (PwMHA) although this effect has not been investigated. Aim We evaluated ex vivo coagulant effects of emicizumabin PwMHA. Methods Clot waveform analysis (CWA) triggered by prothrombin time/activated partial prothrombin time-mixed reagents was utilized to examine coa… Show more

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Cited by 12 publications
(13 citation statements)
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“…Indeed, to prevent or during acute bleedings, additional application of FVIII may be needed in HA patients treated with emicizumab [ 34 ]. Furthermore, also emicizumab-treatment of patients having moderate or acquired HA is currently discussed or already applied [ 35 , 36 ]. While specific quantification of FVIII in the presence of emicizumab can be easily done using a chromogenic assay for FVIII that is based on non-human (bovine) factors and is therefore insensitive to emicizumab, FVIII will inevitably interfere with the determination of emicizumab plasma levels when using both, the mOSA or a chromogenic assay format based on human factors [ 37 ].…”
Section: Discussionmentioning
confidence: 99%
“…Indeed, to prevent or during acute bleedings, additional application of FVIII may be needed in HA patients treated with emicizumab [ 34 ]. Furthermore, also emicizumab-treatment of patients having moderate or acquired HA is currently discussed or already applied [ 35 , 36 ]. While specific quantification of FVIII in the presence of emicizumab can be easily done using a chromogenic assay for FVIII that is based on non-human (bovine) factors and is therefore insensitive to emicizumab, FVIII will inevitably interfere with the determination of emicizumab plasma levels when using both, the mOSA or a chromogenic assay format based on human factors [ 37 ].…”
Section: Discussionmentioning
confidence: 99%
“…Furthermore, there may be concerns related to reduced emicizumab potential in the tenase complex in the presence of dysfunctional FVIII molecules. Recently, Nakajima et al 10 investigated the ex vivo hemostatic effects of emicizumab in PwMHA using clot waveform analysis (CWA). Their reports demonstrated that emicizumab enhanced haemostatic potential in PwMHA, and although further investigations of the in vivo activity of emicizumab in these type of patients are required, the data suggested that emicizumab could be beneficial in PwMHA.…”
Section: Emicizumab Prophylaxis For Non‐inhibitor Patientsmentioning
confidence: 99%
“…Nakajima and colleagues 18 demonstrated in patients with mild/moderate hemophilia that emicizumab increased the ex vivo coagulation potential.…”
Section: Discussionmentioning
confidence: 99%
“…However, due to the relatively small number of patients treated, few bleeding episodes, and short monitoring period, this hypothesis must still be confirmed by real-world clinical data. 1,11,17 Nakajima and colleagues 18 demonstrated in patients with mild/moderate hemophilia that emicizumab increased the ex vivo coagulation potential.…”
Section: Discussionmentioning
confidence: 99%