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Breakthrough Bleeds
Breakthrough Bleeds
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Real-world data shows that breakthrough bleeds continue to happen1,2

The risk of breakthrough bleeds persists, despite therapy with emicizumab1

Study design: An observational study was conducted that analyzed breakthrough bleeding patterns in patients with severe hemophilia A who were prophylactically treated with emicizumab. The study included 70 patients (42 with hemophilia A and 28 with hemophilia A with inhibitors) who completed at least 18 months of follow-up.1

In a real-world study of 70 hemophilia A patients:

51%

51% of patients treated with emicizumab had at least 1 breakthrough spontaneous bleeding episode1
(n=36)

80%

80% of spontaneous bleeds were joint bleeds1

Blood droplet with up arrow icon

The odds of bleeding while on emicizumab increased by a factor of 1.029 (P=0.034) for every 1 year of age1,a

aWithin the 18-month period of emicizumab treatment.

Untreated bleeds persist in patients with hemophilia A with inhibitors2

Study design: A global observational study collected data on people with hemophilia A treated with the standard therapy at the time. The study included adults/adolescents (age ≥12 years) with FVIII inhibitors, children (aged <12 years) with FVIII inhibitors, and adults/adolescents without FVIII inhibitors.2

In a study of 221 hemophilia A patients:

40%

40% of bleeds in people with FVIII inhibitors were untreated2
(n=815)

About 55%

~55% of untreated bleeds in adults/adolescents with FVIII inhibitors treated with emicizumab were in joints2,b
(n=362)

63%

63% of untreated bleeds in adults/adolescents with FVIII inhibitors were spontaneous bleeds2

bIn adults/adolescents with FVIII inhibitors, untreated bleeds in joints were distributed among the knee (28.7%), elbow (21.0%), ankle (15.7%), and other locations (34.6%). In children with FVIII inhibitors, 7.1% of untreated bleeds were in joints, with these most commonly located in the knee (63.6%).2

When and how would you decide to treat a potential breakthrough bleed?

An illustrative patient scenario may help you make the decision.

View case study
Case study illustration

References:

  1. Levy-Mendelovich S, Brutman-Barazani T, Budnik I, et al. Real-world data on bleeding patterns of hemophilia A patients treated with emicizumab. J Clin Med. 2021;10(19):4303.
  2. Callaghan MU, Asikanius E, Lehle M, et al. Untreated bleeds in people with hemophilia A in a noninterventional study and intrapatient comparison after initiating emicizumab in HAVEN 1-3. Res Pract Thromb Haemost. 2022;6(6):e12782.
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