Wolfgang Miesbach: Can Emicizumab Be Used During Breastfeeding?
Wolfgang Miesbach, Head of the Hemostasis and Hemophilia Center at Department of Medicine II, University Hospital Frankfurt, shared a post on LinkedIn about a recent article by Simon Alexander Krooss et al., published in JTH, adding:
“Emicizumab in breast milk: first data.
Postpartum acquired haemophilia A: The mother needs bleed protection, usually wants to carry on breastfeeding, and until now we had nothing to tell her about whether the drug reaches her milk.
A brief report from Hannover (Krooss, Andreas Tiede, Olga Oleshko and colleagues) in JTH: In a woman who developed AHA four months after delivery and continued breastfeeding on emicizumab prophylaxis, emicizumab appeared in milk by day 4 and reached 20 µg/mL by day 8, with a plasma level of 42 µg/mL.
Anti-FVIII IgG and IgA were easily detectable in plasma but in none of the milk samples.
The infant was exclusively breastfed for six months, thrived, and had no bleeding or thrombotic events.
Presence in milk is not the same as exposure of the child.
Gut closure limits uptake of large molecules beyond the first weeks of life, whether any is absorbed systemically is unknown, and in an infant with normal FVIII the pharmacodynamic effect of emicizumab might be reduced.”
Title: Transfer of emicizumab into breast milk in postpartum acquired hemophilia A
Authors: Simon Alexander Krooss, Tim Halling, Dirk Varnholt, Annika Klingberg, Korbinian Brand, Sonja Werwitzke, Heiner Wedemeyer, Christiane Dobbelstein, Andreas Tiede, Olga Oleshko
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