Wolfgang Miesbach: Efficacy, Safety and Thrombosis Signals in Haemophilia A/B with Inhibitors
Wolfgang Miesbach, Professor of Medicine at Frankfurt University Hospital, shared a post on LinkedIn:
”Efficacy, safety and thrombosis signals in haemophilia A/B with inhibitors. This was the last presentation of the 19th EAHAD Congress 2026 (Dublin) by Johnny Mahlangu et al.
In BASIS, once‑weekly SC marstacimab reduced treated ABR from 19.8 to 1.4, lowered annual bypassing agent use, and led to resolution of baseline target joints in 97.1% of patients, with no new target joints over 12 months.
In the BASIS OLE, low ABRs (≈1.2 per year over years 1–3) were maintained, without treatment‑related discontinuations. One participant with inhibitors, multiple comorbidities and intensive perioperative rFVIIa exposure developed cerebral infarction followed by intracerebral haemorrhage more than three years after starting marstacimab and died shortly after discharge.
These events occurred while marstacimab had been administered up to 5 days before surgery and rFVIIa was being used frequently around urological surgery.
To date, two thrombotic events (one venous, one arterial) have been reported in the OLE. Overall, the investigators conclude that SC marstacimab QW reduces bleeding, bypassing agent use and target joints in inhibitor patients with the OLE underlining the need for careful thrombotic risk assessment and perioperative planning when combining non‑factor prophylaxis with bypassing agents.”
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