Balancing the benefits and risks of rebalancing coagulation in haemophilia - PubMed
4 hours ago
- #coagulation
- #haemophilia
- #rebalancing agents
- Rebalancing agents are a new therapeutic class in haemophilia aimed at restoring deficient thrombin generation.
- They work by downregulating natural anticoagulants, inducing a controlled procoagulant shift.
- These agents have shown meaningful reductions in bleeding rates in haemophilia A and B, including in patients with inhibitors.
- The therapeutic window is narrow; excessive thrombin generation may cause thrombosis, while conservative dosing may not prevent bleeding.
- Potential indications include haemophilia B with inhibitors, young children, patients with suboptimal bleed control, and other bleeding disorders.
- Tissue factor pathway inhibitor inhibition may reduce joint bleeding and synovitis due to local tissue expression.
- Patient selection, individualized monitoring, and long-term safety evaluation are crucial for these agents.