New approaches to the diagnosis and treatment of coagulation disorders

Abstract

With the advent of new approaches in coagulation studies capable of identifying regulatory mechanisms involved in transport processes, the spatial localization of processes and interaction between the coagulation system and the immune system, the complement system, and fibrinolysis, the existing diagnostic and treatment approaches used in clinical and laboratory practice are changing as well. This review describes modern diagnostic methods for hemostasis disorders that are based on an integrative approach and are used to assess many aspects of the coagulation system at once. The reviewed methods are sensitive not only to bleeding but also to prothrombotic states, and enable monitoring of treatment with various medications including both oral anticoagulants and antihemophilic agents. We will also cover new approaches to the treatment of hemostasis disorders made possible by the understanding of the involved control mechanisms, such as the use of bispecific antibodies as an alternative to coagulation cofactors, the inhibition of inhibitors and the development of new drug delivery techniques.