Wolfgang Miesbach: Rebalancing Agents in Haemophilia Are Not “Set and Forget” – Key Insights from WFH 2026
Wolfgang Miesbach, Professor of Medicine at Frankfurt University Hospital, shared posts on LinkedIn, highlighting key insights from the World Federation of Hemophilia (WFH) 2026 Congress։
”Rebalancing agents are not ‘set and forget’
Excellent presentation today by Alok Srivastava at the Sanofi industry symposium during WFH Congress Kuala Lumpur on rebalancing agents in haemophilia – showing how different targets (TFPI leads to concizumab / marstacimab; AT leads to fitusiran), loading doses and maintenance intervals (QD / QW / Q2M) demand truly individualised dosing strategies.
- Traditional assays (PT / aPTT) largely unaffected
- PK/PD (where available) help to fine‑tune dose / frequency to maintain target range
- Global assays (TGA / TEG / ROTEM) could be useful in selected settings (e.g. peri‑operative management)
- All dosing decisions embedded in shared decision‑making, patient goals, comorbidities, thrombosis risk
A timely reminder that optimising dose and monitoring is now central to safe and effective haemostatic rebalancing.”
”In the rebalancing era, proactive, protocol‑driven management of any breakthrough bleed has become a fourth pillar of haemophilia care – alongside prophylaxis, monitoring and shared decision‑making.
Interesting summary of treatment recommendations for breakthrough bleeds under rebalancing agents, presented by Alok Srivastava at the Sanofi industry symposium during the WFH Congress in Kuala Lumpur.
- Patient population: haemophilia A/B, ± inhibitors
- Product choice: FVIII/FIX (standard or EHL), aPCC, rFVIIa
- Principle: use the lowest effective dose
- Interval before repeat dosing: typically 24 h vs 5–7 d, depending on product
- Antifibrinolytics: allowed, used with caution or avoided with certain agents.”
Other posts featuring Wolfgang Miesbach on Hemostasis Today.
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Jul 23, 2026, 10:33Johanna Rodríguez: The Structural Challenge of Next-Gen Anticoagulants
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Jul 23, 2026, 10:27Logan Hamilton: New Study Identifies the Mutated Antibody Gene Responsible for VITT
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Jul 23, 2026, 09:05Fonkou Steve: What If We’ve Been Asking the Wrong Question About Plasma Too?
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Jul 23, 2026, 08:27Registration Is Now Open for ASH 2026
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Jul 23, 2026, 08:19Sheeza Nawaz: Why Do Patients With Aortic Stenosis Bleed?
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Jul 23, 2026, 07:59Paschalis Karakasis: Can Left Atrial Appendage Closure Truly Replace Oral Anticoagulation?
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Jul 23, 2026, 06:53Lakmali Silva: What Makes ISTH More Than a Scientific Meeting?
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Jul 23, 2026, 05:48Paschalis Evangelidis: Rethinking Pulmonary Embolism Through the Lens of Thromboinflammation
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Jul 23, 2026, 05:35Neil Morgan: Honoured to Lead the Platelet and Megakaryocyte Theme at ISTH 2026