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Emicizumab in two patients with acquired haemophilia A – case report

Milly Zhao
Milly Zhao
, 
Thomas Kartika
Thomas Kartika
, 
Corey Witenko
Corey Witenko
, 
Jessica Snead
Jessica Snead
, 
Maria T DeSancho
Maria T DeSancho
 und 
Alana Ciolek
Alana Ciolek
   | 02. Aug. 2024
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Article Category: Case Study
Online veröffentlicht: 02. Aug. 2024
Seitenbereich: 92 - 98
DOI: https://doi.org/10.2478/jhp-2024-0016
Schlüsselwörter
© 2024 Milly Zhao et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The cases of two patients with acquired haemophilia A treated with emicizumab suggest its early initiation as part of frontline therapy may reduce episodes of bleeding and reduce the need for bypassing agents
The cases of two patients with acquired haemophilia A treated with emicizumab suggest its early initiation as part of frontline therapy may reduce episodes of bleeding and reduce the need for bypassing agents

Figure 1.

Timeline of events in care of the first patient Days are with respect to the initial presentation. The patient’s coagulation parameters and FVIII levels and inhibitor are shown in relation to administration of haemostatic agents and immunosuppressive therapy (IST) including rituximab and prednisone. On day 67 and 74, the Factor VIII levels on the one-stage assay (FVIII:h) were 273 and 278%, respectively [not shown]. Patient had debridement done on day 70 and initiated on recombinant factor VIIa (rFVIIa), subsequently developing a deep vein thrombus on day 76. aPTT = activated partial thromboplastin time; FVIII:b = chromogenic FVIII measurement using bovine reagent; aPCC = activated prothrombin complex concentrate; LMWH = low molecular weight heparin
Timeline of events in care of the first patient Days are with respect to the initial presentation. The patient’s coagulation parameters and FVIII levels and inhibitor are shown in relation to administration of haemostatic agents and immunosuppressive therapy (IST) including rituximab and prednisone. On day 67 and 74, the Factor VIII levels on the one-stage assay (FVIII:h) were 273 and 278%, respectively [not shown]. Patient had debridement done on day 70 and initiated on recombinant factor VIIa (rFVIIa), subsequently developing a deep vein thrombus on day 76. aPTT = activated partial thromboplastin time; FVIII:b = chromogenic FVIII measurement using bovine reagent; aPCC = activated prothrombin complex concentrate; LMWH = low molecular weight heparin

Figure 2.

Timeline of events in care of the second patient Days are with respect to the initial presentation. The patient’s coagulation parameters and Factor VIII (FVIII) levels and inhibitor are shown in relation to administration of haemostatic agents and immunosuppressive therapy (IST) including intravenous immunoglobulin, prednisone, rituximab, and cyclophosphamide. During recurrence, the patient received 3 doses of emicizumab. Inhibitor level became undetectable three months post relapse. aPTT = activated partial thromboplastin time; FVIII:h = FVIII measurement via one-stage assay; FVIII:b = chromogenic FVIII measurement using bovine reagent; aPCC = activated prothrombin complex concentrate
Timeline of events in care of the second patient Days are with respect to the initial presentation. The patient’s coagulation parameters and Factor VIII (FVIII) levels and inhibitor are shown in relation to administration of haemostatic agents and immunosuppressive therapy (IST) including intravenous immunoglobulin, prednisone, rituximab, and cyclophosphamide. During recurrence, the patient received 3 doses of emicizumab. Inhibitor level became undetectable three months post relapse. aPTT = activated partial thromboplastin time; FVIII:h = FVIII measurement via one-stage assay; FVIII:b = chromogenic FVIII measurement using bovine reagent; aPCC = activated prothrombin complex concentrate
eISSN:
2055-3390
Sprache:
Englisch
Zeitrahmen der Veröffentlichung:
Volume Open
Fachgebiete der Zeitschrift:
Medizin, Vorklinische Medizin, Grundlagenmedizin, andere, Klinische Medizin, Pharmazie, Pharmakologie
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