10 Posts Not to Miss This Week

This week’s posts reflect a rapidly evolving landscape across hematology, thrombosis and cardiovascular medicine, where new guidelines, first-in-class therapies, emerging biomarkers and translational research are continuing to reshape clinical practice.

From the updated ASH 2026 guidelines for immune thrombocytopenia and the FDA approval of nipocalimab for warm autoimmune hemolytic anemia to new insights into Lp(a), oxidized phospholipids and clot strength, these developments highlight how advances in evidence and disease biology are influencing the way we understand and treat hematologic disorders.

The week also brings important perspectives on avacopan-associated liver risk, NLR as a prognostic marker in acute pulmonary embolism, and the expanding role of vaccination in reducing cardiovascular and neurological outcomes.

Alongside these clinical developments, new educational resources such as Pocket Hematology and structural studies using cryo-EM to reveal Factor XIa–Factor IX interactions demonstrate the growing intersection between accessible medical education, basic science and therapeutic innovation.

From updated treatment strategies and newly approved therapies to discoveries at the molecular level, these posts offer a closer look at the evidence, ideas and innovations shaping the future of hematology, hemostasis and thrombosis care.

Isabella Presch, Senior Medical Director Rare diseases, Advanced therapies and Pediatrics at Fortrea:

“Patients don’t measure success by platelet counts alone, but by the ability to live their lives with confidence.

The updated American Society of Hematology 2026 ITP Guidelines place greater emphasis on reducing steroid burden, improving durable responses, and incorporating patient preferences into treatment decisions.

It’s an important step toward care that focuses not only on disease control, but also on quality of life, daily functioning, and outcomes that matter most to patients.”

Melina Rodriguez, Founder of Health Evidence Digest, Senior Medical Editor at Precision AQ:

“Imaavy (Nipocalimab) Receives FDA Approval as the First-Ever Treatment Proven Safe and Effective Specifically for Warm Autoimmune Hemolytic Anemia, Ending Decades of Off-Label Management With Non-Specific Immunosuppression.

On August 24, 2026, the FDA approved Imaavy (nipocalimab-aahu, Johnson and Johnson) as the first-ever treatment proven safe and effective for warm autoimmune hemolytic anemia.

Phase 2/3 ENERGY showed approximately 3x more patients achieved durable hemoglobin response versus placebo; mean hemoglobin improvement began at week

1.Here is how FcRn blockade selectively reduces pathogenic IgG without broad immunosuppression and what the complete trial data shows….”

Sam Tsimikas, Professor of Medicine at the University of California, San Diego:

“The story of Lp(a) and oxidized phospholipids (OxPL)  continues to expand, beyond atherosclerosis and inflammation, and now into clot formation and clot strength.

In our new study in ATVB, Lp(a), OxPL-apoB and other OxPL biomarkers were linked to hypercoagulability and increased tensile clot strength, providing another potential mechanism into how Lp(a) may contribute to atherothrombotic risk.

Particularly intriguing is the connection between Lp(a), oxidized phospholipids (OxPL), coagulation and fibrinolysis, and the formation of stronger clots, and what this may mean as potent Lp(a)-lowering therapies move toward clinical practice.

Many thanks to my terrific co-authors and collaborators Paul Gurbel, Udaya Tantry, Kevin Bliden, William Ashley, and Young Hoon Jeong for making this work possible.

The biology of Lp(a) keeps getting more interesting.”

Maxima Mendez, Chief Executive Officer at Cli-Lipid:

“Just published!

The lipid-lowering landscape is changing and statins are no longer the whole story.

Proud to contribute to this timely review in Frontiers.”

Eric Topol, Founder and Director of Scripps Research Translational Institute:

“Beyond the established Shingles vaccine link to some protection from dementia and Alzheimer’s disease, a large natural experiment provides evidence for a small (nearly 10%) reduction in stroke, heart failure, ischemic heart disease, and atrial fibrillation, broadening the association of benefit Nature Medicine, Maxime Taquet and colleagues.”

John Cush, Editor and CEO RheumNow.com:

“Registry Data Shows Liver Risk With Avacopan

A new study may add fuel to the fire already burning around avacopan (Tavneos), approved in 2021 to treat anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV), which the FDA wants drugmaker Amgen to pull from the U.S. market.”

Luis Oliverio Ambriz Garcia, Doctor, Specialist in Internal Medicine at HRAEB, Chief Executive Officer of Memodi:

“The new American Society of Hematology (ASH, 2026) guidelines for Immune Thrombocytopenia.

Some key points and changes:

• First-line therapy: no longer steroids alone. Rituximab plus steroid or Thrombopoietin Receptor Agonists (TPO-RAs – such as Eltrombopag) plus steroid are suggested.
• Second-line therapy: Thrombopoietin Receptor Agonists (TPO-RAs). Order: TPO-RA then rituximab, then BTKi/MMF/SYKi, then azathioprine.
• Splenectomy: defer for greater than or equal to 1 year, vaccinate greater than or equal to 2 weeks prior, annual follow-up.
• Dosage: steroids for less than or equal to 6 weeks always; dexa 40 mg for 4 days (1–3 cycles) or prednisone 0.5–2 mg/kg/day; rituximab 375 mg/m² for 4 weeks.”

Manuel Monreal, Coordinator of the RIETE registry:

“Neutrophil-to-lymphocyte ratio (NLR) predicts 30-day mortality in patients with acute PE.”

Ali Alkhars, Hematologist at Eastern Health Cluster:

“Every IM resident knows Pocket Medicine – it was our absolute go-to resource on the wards.

But as anyone in the field knows, clinical hematology is a beast.

You are constantly trying to keep the latest WHO classifications, endless CD markers, and treatment protocols straight in your head.

I kept searching for a Pocket Medicine-style resource tailored specifically for heme, but it didn’t exist.

So, I made one.

I am excited to share Pocket Hematology.

It is completely open access.

Download it, share it with your co-hemes, or print a copy for your coat.

Let me know what you think.”

Bassem M. Mohammed, Assistant Professor at Saint Louis University School of Medicine:

“Proud to share that the latest study from our new lab, ‘Structural insights into the exosite-mediated activation of Factor IX by Factor XIa using cryo-EM,’ is officially out in the Journal of Thrombosis and Haemostasis (JTH)!

This project was a true team effort.

A huge shout-out to Samantha Deavila, Tristan Friet, and Isabella Dattilio for their incredible work on protein purification and generation, with special recognition to Isabella Dattilio for kicking off the recombinant protein production and tagging work in the Lab!

We are also deeply grateful to Editor Ton Lisman and the reviewers for their wonderful guidance throughout the publication process.

Using cryo-EM, our lab successfully captured the first high-resolution structures of FXIa bound to its physiological substrate, Factor IX (FIX), and the activated product (FIXab).

Crowning decades of biochemical work, modeling, and biophysical studies, these structures provide direct visual evidence of how the calcium-dependent FIX Gla-domain docks onto the FXIa-A3 exosite and reveal how the catalytic domain of FXIa pivots to accommodate and process the incoming substrate.

We are excited about how this structural template will open doors for designing selective allosteric antithrombotics targeting the contact pathway.”

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