ReviewInternational journal of laboratory hematology2025
Thrombin Generation Assay to Support Hematologists in the Era of New Hemophilia Therapies.
Review in International journal of laboratory hematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Non-Factor Therapies in Haemophilia: The Era of Factor VIII Mimetics and Targeted Rebalancing Agents.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2026Review
- Laboratory Challenges in the Era of Novel Haemophilia Therapies.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2026Review
- Personalized prophylactic therapy optimization in hemophilia A using a hybrid PK-PD-TTE model and deep RL.Journal of pharmacokinetics and pharmacodynamics · 2026Article
- Thrombin generation to predict breakthrough bleeding in patients with acquired hemophilia A under emicizumab prophylaxis.Haematologica · 2026Article
- Hypercoagulability in Light Chain Amyloidosis and the Importance of Predictive Value of TEG and TGT for Thrombosis Recurrence in Inflammatory States.Diagnostics (Basel, Switzerland) · 2026Article
- Prothrombin conversion accelerates with increasing age in women but not in men: findings from the Moli-sani Cohort Study.Research and practice in thrombosis and haemostasis · 2026Article
- New therapies in hemophilia: extend the half-life, mimic, or rebalance?Hematology. American Society of Hematology. Education Program · 2025Review
- Contemporary approaches to treat people with hemophilia: what's new and what's not?Research and practice in thrombosis and haemostasis · 2025Review
- Recent Advances in Gene Therapy for Hemophilia.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
- Acceptability and Determinants for Implementation of the EnzySystem, a Novel Near-Patient Testing Platform for Haemophilia A.Haemophilia : the official journal of the World Federation of HemophiliaArticle
- Real-World Effectiveness and Safety of Concizumab Prophylaxis in Hemophilia: Results From a National French Cohort.Haemophilia : the official journal of the World Federation of HemophiliaObservational
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hematology laboratories have traditionally monitored hemophilia replacement therapy by measuring coagulation factors before and after infusion. However, new drugs that do not rely on the replacement of the deficient factor require new approaches to laboratory monitoring, as factor VIII (FVIII) or factor IX (FIX) assays are no longer adequate. Non-factor therapies come in many different forms, that have one thing in common: they all increase thrombin generation. Their main adverse effect is thrombosis which may occur when too much thrombin is formed. This is the perfect mirror image of anticoagulant treatment, which always diminishes the amount of thrombin formed and has bleeding as its main adverse effect. Thrombin-forming capacity is decreased in congenital bleeding disorders and increased in prothrombotic conditions, indicating it governs bleeding and thrombosis. Therefore, the thrombin generation assay (TGA) is a logical tool for monitoring non-factor therapies, offering a comprehensive assessment of hemostatic balance. TGA identifies patients with severe bleeding, helps to optimize bypassing therapy, and detects hypercoagulability, making it ideal for guiding and monitoring hemophilia treatment with non-factor therapies. It also assesses the efficacy and safety of combined therapies, including non-factor therapies with bypassing agents or FVIII/FIX concentrates. The purpose of this paper is to review the current state of knowledge regarding the use of TGA to monitor novel hemophilia therapies. It will address controversies, limitations, and knowledge gaps related to the integration of TGA into personalized medicine in routine clinical practice.
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