2020 Volume 57 Issue 5 Pages 399-402
Emicizumab is a bispecific antibody used for hemostasis by binding with activated coagulation factor (F) IX and FX rather than activated FVIII. We report on the case of a 6-year-old boy with inhibitor-positive hemophilia A who has been treated with emicizumab. When he was 9 months old, the patient was found to have severe hemophilia A, for which recombinant (r) FVIII was administered as a replacement therapy. When he was 1 year and 7 months old, he had a severe hematoma due to buttocks bruising, and an FVIII inhibitor was detected. The patient received activated prothrombin complex concentrates as a bypass hemostasis therapy and an rFVIII replacement for immune tolerance induction (ITI). Because the FVIII inhibitor has not disappeared, emicizumab has been administered every two weeks since the patient was 5 years and 4 months old. Emicizumab has had excellent prophylactic effects against bleeding, has reduced injection stress, and has improved the quality of life of patients with ITI failure.
