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

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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.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Hämatologie (Erwachsene)

UniBE Contributor:

Angelillo, Anne and Kremer Hovinga, Johanna Anna

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

05 Jan 2021 13:33

Last Modified:

10 Jan 2021 02:52

Publisher DOI:

10.4414/smw.2020.20422

PubMed ID:

33338252

BORIS DOI:

10.7892/boris.149971

URI:

https://boris.unibe.ch/id/eprint/149971

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