Abdul Mannan: 10-Minute FVIII Inhibitor Screening Test
Abdul Mannan, Consultant Haematologist at Betsi Cadwaladr University Health Board, shared a post on LinkedIn about a recent article by Shruti Kharat et al. published in the Journal of Thrombosis and Haemostasis:
”Diagnosing FVIII inhibitors just got a lot simpler.
For years, the Nijmegen-Bethesda Assay has been the only way to confirm an inhibitor in haemophilia A.
It takes 3 to 5 days, needs a coagulation lab, and costs around 200 dollar.
For patients in low-resource settings, that delay can be dangerous.
A new lateral flow test changes that.
Here is what this POC test delivers:
- 10-minute result. Whole blood or plasma. Naked eye reading.
- 98 percent accuracy across 476 samples
- 93 percent sensitivity overall, rising to 100 percent for inhibitors above 2 NBU/mL
- 99 percent specificity and 99 percent NPV
- Cost: approximately 1.50 dollar per test
Not affected by emicizumab, heparin, lupus anticoagulant, or residual FVIII.
That last point matters. Emicizumab makes standard coagulation assays unreliable. This test works alongside it.
With 218,804 people living with haemophilia A globally, and most in countries without specialist lab access, a bedside inhibitor test is not just convenient.
It is a step-change in care.
We still need prospective validation in real-world clinical settings. But the early data is hard to ignore.
Could this replace the NBA in routine screening?
And how would it change your inhibitor workup pathway?”
Title: A rapid point-of-care test for diagnosis of factor VIII inhibitors in haemophilia A patients
Authors: Shruti Kharat, Fiza Jivani, Kranti Patil, Gurpreet Kaur Saini, Anam Dhawlarker, Juili Bharankar, Shrimati Shetty
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