Dilemmas on emicizumab in children with haemophilia A : A survey of strategies from PedNet centres
(2023) In Haemophilia 29(5). p.1291-1298- Abstract
Introduction: Haemophilia A care has changed with the introduction of emicizumab. Experience on the youngest children is still scarce and clinical practice varies between haemophilia treatment centres. Aim: We aimed to assess the current clinical practice on emicizumab prophylaxis within PedNet, a collaborative research platform for paediatricians treating children with haemophilia. Methods: An electronic survey was sent to all PedNet members (n = 32) between October 2022 and February 2023. The survey included questions on the availability of emicizumab, on the practice of initiating prophylaxis in previously untreated or minimally treated patients (PUPs or MTPs) and emicizumab use in patients with or without inhibitors. Results: All... (More)
Introduction: Haemophilia A care has changed with the introduction of emicizumab. Experience on the youngest children is still scarce and clinical practice varies between haemophilia treatment centres. Aim: We aimed to assess the current clinical practice on emicizumab prophylaxis within PedNet, a collaborative research platform for paediatricians treating children with haemophilia. Methods: An electronic survey was sent to all PedNet members (n = 32) between October 2022 and February 2023. The survey included questions on the availability of emicizumab, on the practice of initiating prophylaxis in previously untreated or minimally treated patients (PUPs or MTPs) and emicizumab use in patients with or without inhibitors. Results: All but four centres (28/32; 88%) responded. Emicizumab was available in clinical practice in 25/28 centres (89%), and in 3/28 for selected patients only (e.g. with inhibitors). Emicizumab was the preferred choice for prophylaxis in PUPs or MTPs in 20/25 centres; most (85%) started emicizumab prophylaxis before 1 year of age (30% before 6 months of age) and without concomitant FVIII (16/20; 80%). After the loading dose, 13/28 centres administered the recommended dosing, while the others adjusted the interval of injections to give whole vials. In inhibitor patients, the use of emicizumab during ITI was common, with low-dose ITI being the preferred protocol. Conclusion: Most centres choose to initiate prophylaxis with emicizumab before 12 months of age and without concomitant FVIII. In inhibitor patients, ITI is mostly given in addition to emicizumab, but there was no common practice on how to proceed after successful ITI.
(Less)
- author
- organization
- publishing date
- 2023-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- children, emicizumab, inhibitors, ITI, PUPs, survey
- in
- Haemophilia
- volume
- 29
- issue
- 5
- pages
- 8 pages
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:37647211
- scopus:85169166367
- ISSN
- 1351-8216
- DOI
- 10.1111/hae.14847
- language
- English
- LU publication?
- yes
- id
- e9cc324a-ae57-49a3-b6f9-adb6cf1f79db
- date added to LUP
- 2023-12-01 10:53:15
- date last changed
- 2024-04-14 12:04:55
@article{e9cc324a-ae57-49a3-b6f9-adb6cf1f79db,
abstract = {{<p>Introduction: Haemophilia A care has changed with the introduction of emicizumab. Experience on the youngest children is still scarce and clinical practice varies between haemophilia treatment centres. Aim: We aimed to assess the current clinical practice on emicizumab prophylaxis within PedNet, a collaborative research platform for paediatricians treating children with haemophilia. Methods: An electronic survey was sent to all PedNet members (n = 32) between October 2022 and February 2023. The survey included questions on the availability of emicizumab, on the practice of initiating prophylaxis in previously untreated or minimally treated patients (PUPs or MTPs) and emicizumab use in patients with or without inhibitors. Results: All but four centres (28/32; 88%) responded. Emicizumab was available in clinical practice in 25/28 centres (89%), and in 3/28 for selected patients only (e.g. with inhibitors). Emicizumab was the preferred choice for prophylaxis in PUPs or MTPs in 20/25 centres; most (85%) started emicizumab prophylaxis before 1 year of age (30% before 6 months of age) and without concomitant FVIII (16/20; 80%). After the loading dose, 13/28 centres administered the recommended dosing, while the others adjusted the interval of injections to give whole vials. In inhibitor patients, the use of emicizumab during ITI was common, with low-dose ITI being the preferred protocol. Conclusion: Most centres choose to initiate prophylaxis with emicizumab before 12 months of age and without concomitant FVIII. In inhibitor patients, ITI is mostly given in addition to emicizumab, but there was no common practice on how to proceed after successful ITI.</p>}},
author = {{Ranta, Susanna and Motwani, Jayashree and Blatny, Jan and Bührlen, Martina and Carcao, Manuel and Chambost, Hervé and Escuriola, Carmen and Fischer, Kathelijn and Kartal-Kaess, Mutlu and de Kovel, Marloes and Kenet, Gili and Male, Christoph and Nolan, Beatrice and d'Oiron, Roseline and Olivieri, Martin and Zapotocka, Ester and Andersson, Nadine G. and Königs, Christoph}},
issn = {{1351-8216}},
keywords = {{children; emicizumab; inhibitors; ITI; PUPs; survey}},
language = {{eng}},
number = {{5}},
pages = {{1291--1298}},
publisher = {{Wiley-Blackwell}},
series = {{Haemophilia}},
title = {{Dilemmas on emicizumab in children with haemophilia A : A survey of strategies from PedNet centres}},
url = {{http://dx.doi.org/10.1111/hae.14847}},
doi = {{10.1111/hae.14847}},
volume = {{29}},
year = {{2023}},
}