Journal: Blood advances
This study evaluates the use of emicizumab in managing acquired hemophilia A (AHA), a serious bleeding disorder caused by autoantibodies against factor VIII.
The GTH-AHA-EMI trial assessed whether emicizumab could prevent bleeding during the initial 12 weeks while delaying immunosuppressive therapy (IST), which is conventionally used but associated with high infection-related mortality.
In a 2-year follow-up of 47 patients treated with emicizumab and postponed IST, outcomes were compared to a propensity score–matched historical cohort of 101 patients receiving immediate IST without emicizumab.
Results showed:
- Improved overall survival: 82% vs. 63%
- Reduced infection-related mortality: 4% vs. 16%
- Comparable bleed-related mortality: similar between groups
Although time to complete remission was longer with delayed IST (44 vs. 16 weeks), remission rates were similar (76% vs. 66%).
The study supports that using emicizumab to delay IST in early AHA management is safe, reduces fatal infections, and improves survival.