Inherited coagulopathy

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Benjamin Tillman, MD
Vanderbilt University
Nashville, TN, USA

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3 regimens on this page
3 variants on this page


Guidelines

ASH/ISTH/NHF/WFH

BSH

Factor VIII deficiency (Hemophilia A), replacement products

To be completed

Factor VIII deficiency (Hemophilia A), without inhibitors, all lines of therapy

Emicizumab monotherapy

Regimen

Study Evidence Comparator Comparative Efficacy
Mahlangu et al. 2018 (HAVEN 3) Phase 3 (E-esc) No prophylaxis Lower bleeding rate (primary endpoint)
Negrier et al. 2023 (HAVEN 6) Non-randomized phase 3

Supportive therapy

References

  1. HAVEN 3: Mahlangu J, Oldenburg J, Paz-Priel I, Negrier C, Niggli M, Mancuso ME, Schmitt C, Jiménez-Yuste V, Kempton C, Dhalluin C, Callaghan MU, Bujan W, Shima M, Adamkewicz JI, Asikanius E, Levy GG, Kruse-Jarres R. Emicizumab prophylaxis in patients who have hemophilia A without inhibitors. N Engl J Med. 2018 Aug 30;379(9):811-822. link to original article PubMed NCT02847637
  2. HAVEN 6: Negrier C, Mahlangu J, Lehle M, Chowdary P, Catalani O, Bernardi RJ, Jimenez-Yuste V, Beckermann BM, Schmitt C, Ventriglia G, Windyga J, d'Oiron R, Moorehead P, Koparkar S, Teodoro V, Shapiro AD, Oldenburg J, Hermans C. Emicizumab in people with moderate or mild haemophilia A (HAVEN 6): a multicentre, open-label, single-arm, phase 3 study. Lancet Haematol. 2023 Mar;10(3):e168-e177. Epub 2023 Jan 27. link to original article PubMed NCT04158648

Factor VIII deficiency (Hemophilia A), with inhibitors, all lines of therapy

Emicizumab monotherapy

Regimen

Study Evidence Comparator Comparative Efficacy
Oldenburg et al. 2017 (HAVEN 1) Phase 3 (E-esc) No prophylaxis Lower bleeding rate (primary endpoint)

Supportive therapy

References

  1. HAVEN 1: Oldenburg J, Mahlangu JN, Kim B, Schmitt C, Callaghan MU, Young G, Santagostino E, Kruse-Jarres R, Negrier C, Kessler C, Valente N, Asikanius E, Levy GG, Windyga J, Shima M. Emicizumab prophylaxis in hemophilia A with inhibitors. N Engl J Med. 2017 Aug 31;377(9):809-818. Epub 2017 Jul 10. link to original article PubMed
  2. HAVEN 2: Young G, Liesner R, Chang T, Sidonio R, Oldenburg J, Jiménez-Yuste V, Mahlangu J, Kruse-Jarres R, Wang M, Uguen M, Doral MY, Wright LY, Schmitt C, Levy GG, Shima M, Mancuso ME. A multicenter, open-label phase 3 study of emicizumab prophylaxis in children with hemophilia A with inhibitors. Blood. 2019 Dec 12;134(24):2127-2138. link to original article PubMed

Rituximab monotherapy

Regimen

Study Evidence
Leissinger et al. 2014 Phase 2

Immunosuppressive therapy

7-day cycle for 4 cycles (28-day course)

References

  1. Kempton CL, Allen G, Hord J, Kruse-Jarres R, Pruthi RK, Walsh C, Young G, Soucie JM. Eradication of factor VIII inhibitors in patients with mild and moderate hemophilia A. Am J Hematol. 2012 Sep;87(9):933-6. link to PMC article does not contain dosing details PubMed
  2. Leissinger C, Josephson CD, Granger S, Konkle BA, Kruse-Jarres R, Ragni MV, Journeycake JM, Valentino L, Key NS, Gill JC, McCrae KR, Neufeld EJ, Manno C, Raffini L, Saxena K, Torres M, Marder V, Bennett CM, Assmann SF. Rituximab for treatment of inhibitors in haemophilia A: a phase II study. Thromb Haemost. 2014 Sep 2;112(3):445-58. link to original article link to PMC article PubMed

Factor IX deficiency (Hemophilia B), all lines of therapy

To be completed