Surgical management with emicizumab: Emicizumab will improve but not normalize hemostasis during surgery, so emicizumab alone should not be presumed as adequate for major procedures.
Bypass therapy recommendations for patients with inhibitors.
Patients with congenital hemophilia A or B with inhibitors (CHAwI or CHBwI) are twice as likely to be hospitalized for a bleeding complication.1 NovoSeven® RT is listed among recommended bypassing agents to stop bleeds.2
A first-line treatment option for CHAwI.
Patients receiving emicizumab prophylaxis can still experience breakthrough bleeds and will need concomitant use of alternate hemostatic therapies.3,a
MASAC recommends rFVIIa as a first option to treat acute bleeding episodes in patients on emicizumab—aPCC should be avoided if possible.3
aPlease refer to the full MASAC recommendations document #255 from December 6, 2018 for full guidance around treatment of bleeding episodes and surgery.
Additional MASAC recommendations for CHwI.
rFVIIa should be provided to patients pre- and post-operatively at the discretion of the treating physician.3,a
Safe for your CHBwI patients: NovoSeven® RT is the only bypassing agent not made with any other coagulation factors, such as FIX or FIXa.4,5
MASAC recommends patients with congenital hemophilia B with a history of inhibitors and anaphylaxis not be given FIX-containing products unless bleeding is life-threatening.6
Approved for bleed management
and surgical use in congenital
hemophilia with inhibitors.
Looking for dosing for surgical
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