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We describe the emicizumab rollout and pharmacokinetic strategies and their use in paediatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The evolving real\u2010world experience in using emicizumab has confirmed its safety, efficacy and pharmacokinetic profile in paediatric, adolescent and adult patients receiving emicizumab at various prophylactic dosing regimens. The emicizumab current global rollout includes over 100 countries with 29 low to middle\u2010income countries accessing emicizumab through the World Federation of Haemophilia (WFH) Humanitarian Aid Program. The diversity of emicizumab dosing and pharmacokinetic tools such as the Calibra\u00ae and the WAPPS\u2010Hemo platforms make it possible to achieve prophylaxis goals in line with the WFH Haemophilia treatment guidelines recommendations, with minimal drug wastage. The emerging experience from long term clinical trials and long\u2010term real\u2010world follow\u2010up confirm the safety, efficacy, and pharmacokinetic profile of emicizumab in paediatric haemophilia A patients. A few questions, including inhibitor recurrence, concurrent use of emicizumab with various replacement therapies and inhibitor eradication, are being addressed through multiple ongoing clinical studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The current global rollout of emicizumab is remarkable, and versatile dosing regimens and evolving pharmacokinetic tools such as the Calibra\u00ae and WAPPS\u2010Hemo platforms make it a treatment choice available also for pharmacokinetic guided personalised treatment. Data from paediatric studies are consistent with those seen in adolescent and adult Haemophilia A.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.14524","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T10:07:08Z","timestamp":1651831628000},"page":"103-110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":83,"title":["Emicizumab state\u2010of\u2010the\u2010art update"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5781-7669","authenticated-orcid":false,"given":"Johnny","family":"Mahlangu","sequence":"first","affiliation":[{"name":"Haemophilia Comprehensive Care Centre Charlotte Maxeke Johannesburg Academic Hospital  Johannesburg South Africa"},{"name":"Faculty of Health Sciences University of the Witwatersrand and NHLS  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3331-8766","authenticated-orcid":false,"given":"Alfonso","family":"Iorio","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods Evidence and Impact (HEI)  Ontario Canada"},{"name":"Department of Medicine McMaster University, Hamilton  Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1279-2557","authenticated-orcid":false,"given":"Gili","family":"Kenet","sequence":"additional","affiliation":[{"name":"National Hemophilia, Center Sheba Medical Center  Tel Hashomer Israel"},{"name":"Amalia Biron Research Institute of Thrombosis and Hemostasis Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,6]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"479","article-title":"Factor VIII replacement is still the standard of care in haemophilia A","volume":"17","author":"Aledort L","year":"2019","journal-title":"Blood Transfus"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2021.1961742"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1703068"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1803550"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(19)30054-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019001869"},{"key":"e_1_2_8_8_1","unstructured":"Hemlibra European Medicines Agency (EMA) Marketing Authorisation 2018.https:\/\/www.ema.europa.eu\/en\/news\/first\u2010class\u2010medicine\u2010prevent\u2010bleeding\u2010haemophilia\u2010patients\u2010inhibitors. 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