TY - JOUR AU - Fontana, Pierre AU - Alberio, Lorenzo AU - Albisetti, Manuela AU - Angelillo-Scherrer, Anne AU - Asmis, Lars M. AU - Casini, Alessandro AU - Gerber, Bernhard AU - Graf, Lukas AU - Hegemann, Inga AU - Korte, Wolfgang AU - Martinez, Maria AU - Studt, Jan-Dirk AU - Tsakiris, Dimitrios A. AU - Wuillemin, Walter A. AU - Kremer Hovinga, Johanna A. PY - 2020/12/18 Y2 - 2024/03/29 TI - Management of bleeding events and invasive procedures in patients with haemophilia A without inhibitors treated with emicizumab: A consensus statement of the Working Party on Haemostasis of the Swiss Society of Haematology and the Swiss Haemophilia Network JF - Swiss Medical Weekly JA - Swiss Med Wkly VL - 150 IS - 5153 SE - Review article: Medical guidelines DO - 10.4414/smw.2020.20422 UR - https://smw.ch/index.php/smw/article/view/2933 SP - w20422 AB - <p><strong>INTRODUCTION</strong> <p>Emicizumab (Hemlibra<sup>®</sup>, Hoffmann-La Roche, Switzerland) is now available for haemophilia A patients with or without factor VIII inhibitors. Management of bleeding events and replacement therapy for invasive procedures have to be adapted.</p> <strong>OBJECTIVE</strong> <p>To provide a practical guidance for the management of breakthrough bleeding events and elective or urgent surgery in adult and paediatric patients with haemophilia A without inhibitors treated with emicizumab.</p> <strong>METHODS</strong> <p>Based on the available literature and the experiences collected from adult and paediatric patients treated in Switzerland, the Working Party on Haemostasis of the Swiss Society of Haematology and the Swiss Haemophilia Network worked together to reach a consensus on the management of bleeding events and invasive procedures.</p> <strong>RESULTS AND CONCLUSION</strong> <p>Minor bleeding events and invasive procedures associated with low bleeding risk can be treated without factor replacement therapy in most cases, whereas major bleeding events and high-risk surgery require additional factor VIII replacement at usual doses, at least for the first days. Emicizumab treatment should be continued throughout the procedure and during the postoperative period. Elective major surgery should be planned according to emicizumab dosing for patients with a once-a-month posology. Of note, so far only few data are available on the management of major bleeds and surgery in patients with haemophilia A treated with emicizumab and this practical guidance will have to be regularly updated with growing experience.</p></p> ER -