ArticleBlood vessels, thrombosis & hemostasis2026
Emicizumab enables rapid tolerance, reducing bleeding during low-dose ITI in pediatric hemophilia A.
Article in Blood vessels, thrombosis & hemostasis, 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
Immune tolerance induction (ITI) remains the only proven strategy for eradicating factor VIII (FVIII) inhibitors in severe hemophilia A, yet low-dose regimens are associated with prolonged treatment and significant bleeding. Emicizumab provides FVIII-independent hemostatic protection and may permit antigen exposure under conditions of reduced bleeding and inflammation during ITI. We conducted a single-center cohort study with historical controls to evaluate the impact of emicizumab on low-dose ITI (LD-ITI) outcomes in pediatric patients (aged <14 years) with severe hemophilia A and high-responding inhibitors undergoing their first LD-ITI (50 IU/kg, 3× per week). Twenty-three patients were included. Patients treated with LD-ITI alone (2010-2020; n = 14) were compared with those receiving LD-ITI plus emicizumab prophylaxis (LD-ITI+EMI; 2021-2023; n = 9). Complete ITI success occurred in 7 of 9 patients (78%) of the LD-ITI+EMI cohort vs 5 of 14 patients (36%) of the LD-ITI cohort (
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