Wolfgang Miesbach: A Snake Venom-Derived Factor X Activator for Haemophilia with Inhibitors
Wolfgang Miesbach, Professor of Medicine at Frankfurt University Hospital, shared on LinkedIn about a recent article by Wei Liu et al, published in Blood Advances:
”A snake venom-derived Factor X activator for haemophilia with inhibitors.
Published in Blood Advances, this multicentre phase II trial from China (9 centres, Chinese Academy of Sciences) evaluates bemiltenase alfa, purified from Daboia russelii siamensis (Russell’s viper) venom, as an on-demand haemostatic treatment for patients with haemophilia A or B and inhibitors (HAwI/HBwI).
Inhibitors complicate care in up to 30% of severe HA and 5% of severe HB patients.
Existing bypassing agents show variable efficacy — and crucially, no current non-factor therapy (emicizumab, fitusiran, concizumab) can treat active bleeding.
The mechanism of bemiltenase alfa: It directly activates Factor X — independently of FVIII or FIX — triggering a rapid thrombin burst via the common coagulation pathway.
Results of the clinical study
- Phase IIa: 94.1% effective haemostasis across 135 bleeding episodes
- Phase IIb: 81.9% effective haemostasis across 144 bleeding episodes
- Median time to resolution: 5.5 h from first dose
- Approximately 77% of bleeds controlled with 1–2 doses only
- Rescue therapy required in just 1.4% of episodes
- No serious adverse events, no DIC, no drug-related thromboembolism
How to use it
- IV injection, 0.10 U/kg every 4 hours (up to 6 doses per bleed)
- Half-life ~8 h; onset of APTT reduction and thrombin generation improvement within 10 minutes
- Higher dose (0.16 U/kg) available as escalation for non-responders
- An 8-hour dosing interval is under investigation
FDA Orphan Drug Designation granted June 2024. Phase III trial (NCT06922045) ongoing.”
Title: A specific FX activator for bleeding treatment in hemophilia with inhibitors: multicenter, open-label, phase I/II trials
Authors: Wei Liu, Hu Zhou, Ruibin Huang, Xin Du, Panjing Wang, Zeping Zhou, Changcheng Zheng, Shifeng Lou, Jun Ma, Yanping Song, Xinyue Dai, Xiaomin Wang, Renchi Yang, Lei Zhang
Read the Full Article on Blood Advances
Stay updated on all scientific advances with Hemostasis Today.
-
Sep 25, 2026, 09:49Haley Coleman: Volunteering to Support Hemophilia Awareness
-
Sep 25, 2026, 08:55Hitarth Mehta: BHMS Students Gain Practical Exposure to Haemophilia Diagnosis
-
Sep 25, 2026, 07:25Varun Capoor: How Therapeutic Apheresis and Transfusion Medicine Can Complement Clinical Management in SCD
-
Sep 25, 2026, 07:14Manshi Kesharwani: SAK-GQDs Modulate Thrombus Burden and Endothelial Function in Deep Vein Thrombosis
-
Sep 25, 2026, 06:20Farjah Hassan Algahtani: How Can We Better Identify Patients at Risk of Blood Clots after Metabolic and Bariatric Surgery?
-
Sep 25, 2026, 05:59Carla Lewis: Kids Conquering Sickle Disease Joins Nemours Children’s Hospital for 2nd Annual Awareness Event
-
Sep 25, 2026, 05:47Omid Seidizadeh: Evolutionary Constraint and Population Variation Across Coagulation Genes
-
Sep 25, 2026, 05:40Gerald Bertrand: Presenting UMi-NGS Non-Invasive Foetal HPA Genotyping at DGTI 2026
-
Sep 25, 2026, 05:33Urge Congress to support the Sickle Cell Disease Comprehensive Care Act – ASH