Emicizumab (anti-Factor IX)

Emicizumab is used for the prevention and control of bleeding episodes in patients with hemophilia A, including those with factor VIII inhibitors. It functions as a bispecific monoclonal antibody that bridges activated factor IX and factor X, restoring the coagulation cascade similar to factor VIII. This allows for effective hemostasis without replacing factor VIII directly. It is administered subcutaneously, offering a convenient dosing schedule—weekly, every two weeks, or even every four weeks—improving patient compliance compared to frequent intravenous infusions of traditional factor replacement therapies. Emicizumab is effective in both congenital and acquired hemophilia A and is used across all age groups, including children and adults. It significantly reduces the frequency of bleeding episodes, including spontaneous bleeds in joints and muscles, and helps prevent long-term joint damage. Importantly, it is not a treatment for acute bleeding episodes but is used as a prophylactic therapy. Caution is required when using coagulation bypassing agents (like activated prothrombin complex concentrate) due to the risk of thrombotic events.

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