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Volume 15
Issue 4
10.3390/hematolrep15040062
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Article

Management and Outcomes of Invasive Procedures in Individuals with Hemophilia A on Emicizumab Prophylaxis: A Single Center Experience

by
Karla Rener
1,2,
Saša Anžej Doma
1,2,
Martina Fink
1,
Helena Podgornik
1,3 and
Irena Preložnik Zupan
1,2,*
1
Department of Hematology, University Medical Center Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia
2
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
3
Faculty of Pharmacy, University of Ljubljana, Aškerčeva cesta 7, 1000 Ljubljana, Slovenia
*
Author to whom correspondence should be addressed.
Hematol. Rep. 2023, 15(4), 597-607; https://doi.org/10.3390/hematolrep15040062
Submission received: 28 April 2023 / Revised: 12 July 2023 / Accepted: 25 October 2023 / Published: 1 November 2023
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Abstract

Prophylactic treatment with emicizumab has become an important and effective bleeding prevention for people with hemophilia A (PwHA). Perioperative management of PwHA using emicizumab prophylaxis is still challenging due to a lack of experience. Medical records of perioperative management and outcomes were reviewed, and data were collected for adult PwHA receiving emicizumab and undergoing surgical procedures between August 2019 and July 2022 at the University Medical Center Ljubljana. Twelve surgical procedures were performed in eight PwHA (one with FVIII inhibitors) while on emicizumab prophylaxis. Three minor procedures included cataract surgery, cystoscopic lithotripsy, and percutaneous coronary intervention. Nine major surgeries included four osteosyntheses, necrectomy of chronic osteomyelitis with new ankle arthrodesis, two below-knee amputations, total knee replacement, and placement of ventriculostomy after a spontaneous intraventricular hemorrhage. No major bleeds, thrombotic events or deaths, or new inhibitors appeared. Our real-world experience demonstrates that minor and major surgeries can be performed safely in PwHA on emicizumab prophylaxis. Additional data are needed to optimize dosing/duration of additional hemostatic agents in diverse invasive procedures and complex clinical situations.
Keywords: emicizumab; prophylaxis; hemophilia A; factor VIII; factor FVIIa; invasive procedures; perioperative care emicizumab; prophylaxis; hemophilia A; factor VIII; factor FVIIa; invasive procedures; perioperative care
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MDPI and ACS Style

Rener, K.; Anžej Doma, S.; Fink, M.; Podgornik, H.; Preložnik Zupan, I. Management and Outcomes of Invasive Procedures in Individuals with Hemophilia A on Emicizumab Prophylaxis: A Single Center Experience. Hematol. Rep. 2023, 15, 597-607. https://doi.org/10.3390/hematolrep15040062

AMA Style

Rener K, Anžej Doma S, Fink M, Podgornik H, Preložnik Zupan I. Management and Outcomes of Invasive Procedures in Individuals with Hemophilia A on Emicizumab Prophylaxis: A Single Center Experience. Hematology Reports. 2023; 15(4):597-607. https://doi.org/10.3390/hematolrep15040062

Chicago/Turabian Style

Rener, Karla, Saša Anžej Doma, Martina Fink, Helena Podgornik, and Irena Preložnik Zupan. 2023. "Management and Outcomes of Invasive Procedures in Individuals with Hemophilia A on Emicizumab Prophylaxis: A Single Center Experience" Hematology Reports 15, no. 4: 597-607. https://doi.org/10.3390/hematolrep15040062

APA Style

Rener, K., Anžej Doma, S., Fink, M., Podgornik, H., & Preložnik Zupan, I. (2023). Management and Outcomes of Invasive Procedures in Individuals with Hemophilia A on Emicizumab Prophylaxis: A Single Center Experience. Hematology Reports, 15(4), 597-607. https://doi.org/10.3390/hematolrep15040062

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