ArticleResearch and practice in thrombosis and haemostasis2026
Augmented emicizumab-driven coagulation potential in hemophilia A state by
Article in Research and practice in thrombosis and haemostasis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Persons with hemophilia A (HA) and inhibitors undergoing emicizumab prophylaxis require bypassing agents when breakthrough bleeding occurs. Recent studies have demonstrated that either factor (F)IX or FX supplementation can improve coagulation potential of emicizumab-treated persons with HA and inhibitors. Objectives: This study assessed the effect of combined supplementation with FIX and FX on the coagulation potential in emicizumab-treated HA state. Methods: FVIII-deficient plasmas were spiked with emicizumab (50 μg/mL), FX (100 IU/dL), and various FIX levels (100-1600 IU/dL). Plasmas from emicizumab-treated persons with HA and inhibitors were also added with FIX/FX (100 IU/dL each). Coagulation potential was assessed by maximum coagulation velocity (Ad|min1|) using tissue factor (TF)/ellagic acid-triggered clot waveform analysis and peak thrombin (PeakTh) using TF-triggered thrombin generation assay. For Results: Ad|min1| and PeakTh in FVIII-deficient plasmas with emicizumab, FIX, and FX increased in FIX dose dependently. Addition of FIX and FX (100 IU/dL each) to emicizumab-supplemented FVIII-deficient plasma and plasma of emicizumab-treated persons with HA and inhibitor improved both parameters to normal levels. CT+CFT and blood loss in emicizumab-HA mice with additional hFIX/hFX (100 IU/dL each) administration were significantly shorter and decreased than those in emicizumab-HA mice. The thrombotic markers largely did not change. Conclusion: Combined FIX and FX supplementation could enhance coagulation potential in emicizumab-treated persons with HA and inhibitors.
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