Non‐factor therapies for bleeding disorders: A primer for the general haematologist

Bibliographic Details
Title: Non‐factor therapies for bleeding disorders: A primer for the general haematologist
Authors: Dawn Swan, Johnny Mahlangu, Jecko Thachil
Source: eJHaem, Vol 3, Iss 3, Pp 584-595 (2022)
Publisher Information: Wiley, 2022.
Publication Year: 2022
Collection: LCC:Diseases of the blood and blood-forming organs
Subject Terms: concizumab, emicizumab, fitusiran, haemophilia, von Willebrand disease, Diseases of the blood and blood-forming organs, RC633-647.5
More Details: Abstract Management of patients with severe bleeding disorders, particularly haemophilia A and B, and to a lesser extent, von Willebrand disease, has come on leaps and bounds over the past decade. Until recently, patients relied upon the administration of factor concentrates to prevent or treat bleeding episodes. Factor administration requires intravenous access and, in up to one‐third of patients, leads to the development of neutralising antibodies, or inhibitors, which are associated with more frequent bleeding episodes and higher morbidity. Novel non‐factor therapies may offer a solution to these unmet needs. In this review, we discuss the factor mimetics, particularly emicizumab, and the rebalancing agents, which inhibit antithrombin, tissue factor pathway inhibitor and activated protein C, and novel treatments to enhance von Willebrand factor levels. We review the available trial data, unanswered questions and challenges associated with these new treatment modalities. Finally, we provide practical management algorithms to aid the general haematologist when faced with a patient receiving emicizumab who requires surgery or may develop bleeding.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2688-6146
Relation: https://doaj.org/toc/2688-6146
DOI: 10.1002/jha2.442
Access URL: https://doaj.org/article/d0f202d1a66548f3a00da42106dcb578
Accession Number: edsdoj.0f202d1a66548f3a00da42106dcb578
Database: Directory of Open Access Journals
More Details
ISSN:26886146
DOI:10.1002/jha2.442
Published in:eJHaem
Language:English