Management of bleeding events and invasive procedures in patients with haemophilia A without inhibitors treated with emicizumab.

Fontana, Pierre; Alberio, Lorenzo; Albisetti, Manuela; Angelillo, Anne; Asmis, Lars M; Casini, Alessandro; Gerber, Bernhard; Graf, Lukas; Hegemann, Inga; Korte, Wolfgang; Martinez, Maria; Studt, Jan-Dirk; Tsakiris, Dimitrios A; Wuillemin, Walter A; Kremer Hovinga, Johanna A. (2020). Management of bleeding events and invasive procedures in patients with haemophilia A without inhibitors treated with emicizumab. Swiss medical weekly, 150, w20422. EMH Schweizerischer Ärzteverlag 10.4414/smw.2020.20422

Preview

Text smw_2020_20422.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND). Download (790kB) | Preview

INTRODUCTION

Emicizumab (Hemlibra®, Hoffmann-La Roche, Switzerland) is now available for haemophilia A patients with or without factor VIII inhibitors. Management of bleeding events and replacement therapy for invasive procedures have to be adapted.

OBJECTIVE

To provide a practical guidance for the management of breakthrough bleeding events and elective or urgent surgery in adult and paediatric patients with haemophilia A without inhibitors treated with emicizumab.

METHODS

Based on the available literature and the experiences collected from adult and paediatric patients treated in Switzerland, the Working Party on Haemostasis of the Swiss Society of Haematology and the Swiss Haemophilia Network worked together to reach a consensus on the management of bleeding events and invasive procedures.

RESULTS AND CONCLUSION

Minor bleeding events and invasive procedures associated with low bleeding risk can be treated without factor replacement therapy in most cases, whereas major bleeding events and high-risk surgery require additional factor VIII replacement at usual doses, at least for the first days. Emicizumab treatment should be continued throughout the procedure and during the postoperative period. Elective major surgery should be planned according to emicizumab dosing for patients with a once-a-month posology. Of note, so far only few data are available on the management of major bleeds and surgery in patients with haemophilia A treated with emicizumab and this practical guidance will have to be regularly updated with growing experience. &nbsp.

Interest & Impact

Downloads

87 since deposited on 05 Jan 2021
27 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item