Successful emicizumab prophylaxis during dual antiplatelet therapy for insertion of drug‐eluting stents after acute coronary syndrome: A case report

Nagao, Azusa; Koganei, Hiroshi; Yamaguchi, Tomoko; Fukutake, Katsuyuki

doi:10.1111/hae.14305

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Modified European Society of Cardiology (ESC) guidelines for PwHA without inhibitors on emicizumab prophylaxis concluded with a 70% expert consensus that there is no need for additional factor replacement during DAPT [19]. Nagao and co-workers reported successful two-months bleeding protection with emicizumab during DAPT in a PwHA; however, administration of rFVIII every other day to maintain a FVIII trough of 0.15-0.3 IU/mL was deemed too burdensome [20]. In our PwHA cohort, equivalent activity of FVIII (CSA-H) while on emicizumab was between 9% and 11%.…”

Section: Discussionmentioning

confidence: 99%

Management and Outcomes of Invasive Procedures in Individuals with Hemophilia A on Emicizumab Prophylaxis: A Single Center Experience

Rener,

Anžej Doma,

Fink

et al. 2023

Hematology Reports

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Prophylactic treatment with emicizumab has become an important and effective bleeding prevention for people with hemophilia A (PwHA). Perioperative management of PwHA using emicizumab prophylaxis is still challenging due to a lack of experience. Medical records of perioperative management and outcomes were reviewed, and data were collected for adult PwHA receiving emicizumab and undergoing surgical procedures between August 2019 and July 2022 at the University Medical Center Ljubljana. Twelve surgical procedures were performed in eight PwHA (one with FVIII inhibitors) while on emicizumab prophylaxis. Three minor procedures included cataract surgery, cystoscopic lithotripsy, and percutaneous coronary intervention. Nine major surgeries included four osteosyntheses, necrectomy of chronic osteomyelitis with new ankle arthrodesis, two below-knee amputations, total knee replacement, and placement of ventriculostomy after a spontaneous intraventricular hemorrhage. No major bleeds, thrombotic events or deaths, or new inhibitors appeared. Our real-world experience demonstrates that minor and major surgeries can be performed safely in PwHA on emicizumab prophylaxis. Additional data are needed to optimize dosing/duration of additional hemostatic agents in diverse invasive procedures and complex clinical situations.

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Section: Discussionmentioning

confidence: 99%

Management and Outcomes of Invasive Procedures in Individuals with Hemophilia A on Emicizumab Prophylaxis: A Single Center Experience

Rener,

Anžej Doma,

Fink

et al. 2023

Hematology Reports

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“…Near‐normal lifespans of PwH in conjunction with improved haemostatic levels have led to an increased need to manage age‐related comorbidities. Historically, the bleeding risk in PwH precluded antithrombotic therapy; now sustained haemostasis with current prophylaxis regimens allows antithrombotic therapy in selected individuals 47 …”

Section: Challenges In Patient Managementmentioning

confidence: 99%

“…Historically, the bleeding risk in PwH precluded antithrombotic therapy; now sustained haemostasis with current prophylaxis regimens allows antithrombotic therapy in selected individuals. 47 Hypertension is a strong risk factor for mortality and CVD. 48 Several historical studies suggested a higher prevalence of hypertension in PwH, the pathophysiology of which is poorly defined.…”

Section: Cardiovascular Diseasementioning

confidence: 99%

Therapeutic and technological advancements in haemophilia care: Quantum leaps forward

Lewandowska

Nasr²,

Shapiro

2022

Haemophilia

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Introduction Recent technological innovations in haemophilia have advanced at an astounding pace, including gene therapy programmes and bioengineered molecules for prophylaxis, products that reduce treatment burden through half‐life extension, unique mechanisms of action, and subcutaneous administration. Additional technological advancements have emerged that are anticipated to further transform haemophilia care. Aim Review new and emerging haemophilia therapies, including replacement and bypassing products, digital applications, utilisation of big data, and personalised medicine. Methods Data were obtained from peer‐reviewed presentations/publications, and ongoing studies in haemophilia, ultrasonography, and artificial intelligence (AI). Results Available treatments include new recombinant factors VIII (FVIII) and IX (FIX), extended half‐life FVIII/IX products, a new FVIIa product for inhibitor patients, and a FVIIIa‐mimetic. Several novel therapeutics are in clinical trials, including FVIIIa mimetics and inhibitors of naturally‐occurring anticoagulants. Ongoing gene therapy trials suggest that a single vector infusion using an optimised construct can produce factor activity that reduces bleeding to near zero for years. Today, persons with haemophilia (PwH) approach a lifespan comparable to that of the general population, presenting treatment challenges for age‐related co‐morbidities. Technological innovations have broadened beyond therapeutics to include large database analyses utilising remote data collection with handheld devices, and to tailor AI applications. Current development efforts include patient‐performed ultrasonography, algorithms for scan interpretation, and point‐of‐care haemostatic testing devices. Conclusions We have entered a golden age for haemophilia treatment and care with wide‐ranging advancements targeting improved quality of life (QoL). Future‐focused efforts by clinical and patient communities may provide equitable access and care for people impacted by haemophilia worldwide.

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Emicizumab: a novel drug in hemophilia A prophylaxis – a narrative review

Mazurkiewicz

Czernikiewicz

Rupa‐Matysek

et al. 2022

Expert Review of Hematology

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Successful emicizumab prophylaxis during dual antiplatelet therapy for insertion of drug‐eluting stents after acute coronary syndrome: A case report

Cited by 4 publications

References 6 publications

Management and Outcomes of Invasive Procedures in Individuals with Hemophilia A on Emicizumab Prophylaxis: A Single Center Experience

Management and Outcomes of Invasive Procedures in Individuals with Hemophilia A on Emicizumab Prophylaxis: A Single Center Experience

Therapeutic and technological advancements in haemophilia care: Quantum leaps forward

Emicizumab: a novel drug in hemophilia A prophylaxis – a narrative review

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