PT  - JOURNAL ARTICLE
AU  - Nardi, Michael A.
TI  - Emicizumab and the Clinical Coagulation Laboratory
AID  - 10.29074/ascls.2019002204
DP  - 2020 Jul 01
TA  - American Society for Clinical Laboratory Science
PG  - 37--47
VI  - 33
IP  - 3
4099  - http://hwmaint.clsjournal.ascls.org/content/33/3/37.short
4100  - http://hwmaint.clsjournal.ascls.org/content/33/3/37.full
SO  - Clin Lab Sci2020 Jul 01; 33
AB  - Emicizumab, a novel therapeutic agent for patients with hemophilia A (HA), is a humanized, asymmetric, bispecific, IgG4 monoclonal antibody designed to mimic the function of activated factor VIII (FVIII). Clinical studies have demonstrated its utility in the successful treatment of HA patients with and without anti-FVIII alloantibodies. The conventional methods currently used for monitoring management of HA will be discussed along with why they may be inappropriate for patients receiving emicizumab. Alternative methods (ie, global testing) will be presented and discussed in the context of emicizumab. With the increasing availability of treatment with emicizumab, it is important the clinical laboratory understands the mechanism, interaction with conventional coagulation assays, and alternative methods for its monitoring. This review describes and discusses the different assays used to measure the effectiveness of emicizumab as well as monitor FVIII activity in patients with HA.