Management of people with haemophilia A undergoing surgery while receiving emicizumab prophylaxis: Real‐world experience from a large comprehensive treatment centre in the US

• DOI: 10.1111/hae.14212
• Publication Date: 2020-11-27T22:14:30Z
• Authors: Magdalena Lewando...; Nicole Randall; Nihal Bakeer; Jennifer Maahs; Jeanne Sagar; Anne Greist; Amy D. Shapiro
• Keywords: Bleed

Introduction Surgery is frequently required in persons with haemophilia A (PwHA). Emicizumab, a bispecific, humanized monoclonal antibody, bridges activated factor (F) IX and FX. Management of patients undergoing surgery while receiving emicizumab clinical interest due to paucity data. Aim Review real-world experience PwHA with/without FVIII inhibitors who prophylaxis. Methods Data regarding peri-operative management, including type surgery, haemostatic agent use bleeding complications, were collected for between 25/10/18 31/12/19 at the Indiana Hemophilia Thrombosis Center. Analyses exploratory descriptive. Results Twenty minor five major surgeries performed 17 patients, respectively. Overall, 9/20 planned occur as sole agent; these, four additional coagulation (2 haematomas following port removals, 1 oozing removal site, squamous cell carcinoma removal). Three 11 resulted non-major bleeds; all safely managed factor. All agents; there was bleed patient elbow synovectomy nerve transposition, likely triggered by physical/occupational therapy. There no bleeds, thrombotic events or deaths. Conclusions Additional safe emicizumab. data are needed determine optimal dosing/length treatment agents lower risk.