Emicizumab Brand Name– Hemlibra
What is Emicizumab
Emicizumab is a humanized monoclonal modified immunoglobulin G4 (IgG4) antibody with a bispecific antibody structure binding factor IXa and factor X used for routine prophylaxis of bleeding episodes in adult and pediatric patients with hemophilia A (congenital factor VIII deficiency) with or without factor VIII inhibitors.
Emicizumab bridges factor IX and factor X to restore the function of missing factor VIII that is needed for effective hemostasis.
In adults and adolescents with factor VIII inhibitors, emicizumab was associated with an 87% lower bleeding rate compared to those who did not receive treatment during clinical trials.
In those without factor FVIII inhibitors, emicizumab prophylaxis resulted in a 96% to 97% reduction in bleeding rate. Interim data from a pediatric study of children younger than 11 years of age demonstrated a no bleed rate of 86.4% for patients treated with emicizumab over a median observation period of 29.6 weeks.
Thrombotic microangiopathy and thrombotic events have been reported when, on average, a cumulative amount of more than 100 units/kg/24 hours of activated prothrombin complex concentrate (aPCC) was administered for 24 hours or more to patients receiving emicizumab.
The benefits and risks of coadministering aPCC with emicizumab must be carefully weighed
Indications
- bleeding prophylaxis
- hemophilia A
Side Effects
- antibody formation
- arthralgia
- diarrhea
- erythema
- fever
- headache
- hematoma
- hemolytic anemia
- injection site reaction
- pruritus
- rash
- rhabdomyolysis
- thrombocytopenia
- thromboembolism
- thrombosis
- thrombotic microangiopathy
- urticaria
Monitoring Parameters
- clotting inhibitor titers
Contraindications
- breast-feeding
- contraception requirements
- laboratory test interference
- pregnancy
- reproductive risk
- thromboembolism
Interactions
- Anti-inhibitor Coagulant Complex
- Antihemophilic Factor, AHF, Factor VIII
- Antihemophilic Factor, Fc Fusion Protein, Recombinant
- Antihemophilic Factor, Porcine Sequence, Recombinant
- Factor VIIa, Recombinant
