PMID- 35060654
OWN - NLM
STAT- MEDLINE
DCOM- 20220314
LR  - 20220314
IS  - 1365-2516 (Electronic)
IS  - 1351-8216 (Linking)
VI  - 28
IP  - 2
DP  - 2022 Mar
TI  - Emicizumab does not interfere with the activated clotting time.
PG  - 362-366
LID - 10.1111/hae.14497 [doi]
AB  - INTRODUCTION: The activated clotting time (ACT) is a useful marker of 
      unfractionated heparin (UFH) activity during cardiopulmonary bypass (CPB) or 
      cardiac catheterization. Emicizumab, recently approved for bleeding prevention in 
      haemophilia A patients, acts like FVIII but does not need prior activation; it 
      therefore shortens coagulation times in assays using intrinsic pathway activators 
      and so is expected to shorten the ACT. AIM: To evaluated emicizumab's impact on 
      heparin-induced ACT (Hemochron(R)) prolongation. METHODS: We measured the 
      high-range (HR) ACT in citrated blood samples from healthy donors (HDs) (n = 9), 
      CPB patients (n = 3) and emicizumab-treated patients (n = 5) after spiking with 
      UFH and/or emicizumab. The low range (LR) ACT was also measured in spiked-samples 
      from HDs and emicizumab-treated patients. RESULTS: In HDs, the median 
      [interquartile range] baseline HR-ACTs were similar with and without emicizumab 
      (129 [123-138] and 136 [115-141] s for 50 mug/ml, respectively); whatever the 
      concentration of emicizumab (10 to 50 mug/ml), increasing the UFH concentration 
      (1-5 UI/ml) prolonged the HR-ACT. In blood from patients undergoing CPB, the 
      HR-ACT prolongation observed during this procedure was not masked by emicizumab 
      at any concentration. Likewise, the addition of increasing concentrations of UFH 
      to blood from emicizumab-treated patients induced a concentration-dependent 
      prolongation of HR-ACT. Baseline LR-ACT were prolonged in emicizumab-treated 
      patients but as for HR-ACT, emicizumab does not prevent heparin-induced 
      prolongation of LR-ACT. CONCLUSION: Emicizumab does not interfere with 
      UFH-induced ACT prolongation. The hemochron(R) ACT can be used to monitor UFH in 
      patients receiving emicizumab during CPB or cardiac catheterization.
CI  - (c) 2022 John Wiley & Sons Ltd.
FAU - Capdevila, Ladislas
AU  - Capdevila L
AD  - Haematology Laboratory, AP-HP, Hopital Universitaire Necker-Enfants Malades, 
      Paris, France.
FAU - Frere, Corinne
AU  - Frere C
AD  - INSERM UMRS_1166, Institute of Cardiometabolism and Nutrition, Sorbonne 
      Universite, Paris, France.
AD  - Haematology Laboratory, AP-HP, Hopital Universitaire Pitie-Salpetriere, Paris, 
      France.
FAU - Desvages, Maximilien
AU  - Desvages M
AD  - Haematology Laboratory, AP-HP, Hopital Universitaire Necker-Enfants Malades, 
      Paris, France.
AD  - HITh, UMR_S 1176, INSERM, Universite Paris-Saclay, Le Kremlin-Bicetre, France.
FAU - Harroche, Annie
AU  - Harroche A
AD  - Centre de Traitement de l'Hemophilie, AP-HP, Hopital Universitaire Necker-Enfants 
      Malades, Paris, France.
FAU - Bally, Cecile
AU  - Bally C
AD  - Centre de Traitement de l'Hemophilie, AP-HP, Hopital Universitaire Necker-Enfants 
      Malades, Paris, France.
FAU - Abbes, Ahmed
AU  - Abbes A
AD  - GRC 29; Department of Anaesthesiology and Critical Care Medicine, AP-HP, Sorbonne 
      Universite, Hopital Universitaire Pitie-Salpetriere, Paris, France.
FAU - d'Oiron, Roseline
AU  - d'Oiron R
AUID- ORCID: 0000-0002-4843-7805
AD  - HITh, UMR_S 1176, INSERM, Universite Paris-Saclay, Le Kremlin-Bicetre, France.
AD  - Service d'hematologie, AP-HP, Hopital de Bicetre, Le Kremlin-Bicetre, France.
FAU - Frenzel, Laurent
AU  - Frenzel L
AUID- ORCID: 0000-0002-6085-2163
AD  - Centre de Traitement de l'Hemophilie, AP-HP, Hopital Universitaire Necker-Enfants 
      Malades, Paris, France.
FAU - Borgel, Delphine
AU  - Borgel D
AD  - Haematology Laboratory, AP-HP, Hopital Universitaire Necker-Enfants Malades, 
      Paris, France.
AD  - HITh, UMR_S 1176, INSERM, Universite Paris-Saclay, Le Kremlin-Bicetre, France.
FAU - Lasne, Dominique
AU  - Lasne D
AUID- ORCID: 0000-0001-6600-0263
AD  - Haematology Laboratory, AP-HP, Hopital Universitaire Necker-Enfants Malades, 
      Paris, France.
AD  - HITh, UMR_S 1176, INSERM, Universite Paris-Saclay, Le Kremlin-Bicetre, France.
LA  - eng
PT  - Journal Article
DEP - 20220121
PL  - England
TA  - Haemophilia
JT  - Haemophilia : the official journal of the World Federation of Hemophilia
JID - 9442916
RN  - 0 (Antibodies, Bispecific)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 7NL2E3F6K3 (emicizumab)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - *Antibodies, Bispecific/pharmacology/therapeutic use
MH  - Antibodies, Monoclonal, Humanized/pharmacology/therapeutic use
MH  - *Heparin/pharmacology/therapeutic use
MH  - Humans
MH  - Whole Blood Coagulation Time
OTO - NOTNLM
OT  - activated clotting time
OT  - cardiac catheterization
OT  - cardiopulmonary bypass
OT  - emicizumab
OT  - haemophilia
OT  - unfractionated heparin
EDAT- 2022/01/22 06:00
MHDA- 2022/03/15 06:00
CRDT- 2022/01/21 08:59
PHST- 2021/12/10 00:00 [revised]
PHST- 2021/09/01 00:00 [received]
PHST- 2022/01/09 00:00 [accepted]
PHST- 2022/01/22 06:00 [pubmed]
PHST- 2022/03/15 06:00 [medline]
PHST- 2022/01/21 08:59 [entrez]
AID - 10.1111/hae.14497 [doi]
PST - ppublish
SO  - Haemophilia. 2022 Mar;28(2):362-366. doi: 10.1111/hae.14497. Epub 2022 Jan 21.