{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T01:59:03Z","timestamp":1767664743756,"version":"3.40.5"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Emicizumab is used as hemostatic prophylaxis for patients with hemophilia A (PwHA), irrespective of the presence of inhibitors. Although bacterial infection can lead to a procoagulant state, there is limited information on coagulation and fibrinolysis potentials in emicizumab\u2010treated PwHA and on the use of anticoagulants in such cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>We examined whether anticoagulants affect the coagulation and fibrinolysis potentials in plasma from PwHA spiked with emicizumab.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Plasma from PwHA was in vitro supplemented with emicizumab (50\u00a0\u03bcg\/mL; emi\u2010plasma) and anticoagulants (recombinant thrombomodulin (rTM), nafamostat mesylate (NM), unfractionated heparin (UFH), or low\u2010molecular\u2010weight heparin (LMH)). PwHA plasma spiked with rFVIII (1 IU\/mL) was used as a reference (ref\u2010plasma). The coagulation and fibrinolysis potentials in plasma was measured by thrombin and plasmin generation assay (T\/P\u2010GA) and clot\u2010fibrinolysis waveform analysis (CFWA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In T\/P\u2010GA and CFWA, coagulation potentials (maximum coagulation velocity; |min1|, and peak thrombin; Th\u2010Peak) in plasma rose with increasing concentrations of emicizumab and rFVIII, but fibrinolytic potentials (peak plasmin; Plm\u2010Peak, and maximum fibrinolytic velocity; |FL\u2010min1|) remained unchanged. Adding rTM, NM, and UFH to emi\u2010plasma suppressed coagulation and fibrinolysis potentials, similar to ref\u2010plasma. Regarding the heparin, UFH and LMH inhibited the improved coagulation in emi\u2010plasma. UFH inhibited fibrinolysis as well, but LMH did not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Anticoagulants could exhibit the inhibitory effects on the coagulation and fibrinolysis potentials in plasma from PwHA spiked with emicizumab, similar to those in normal plasma.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.14877","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T06:14:57Z","timestamp":1695881697000},"page":"1529-1538","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The in vitro effect of anticoagulant agents on coagulation and fibrinolysis in the presence of emicizumab in the plasmas from patients with haemophilia A"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0199-7645","authenticated-orcid":false,"given":"Tomoko","family":"Onishi","sequence":"first","affiliation":[{"name":"Department of Pediatrics Nara Medical University  Kashihara Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suguru","family":"Harada","sequence":"additional","affiliation":[{"name":"Chugai Pharmaceutical Co., Ltd.  Yokohama Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanako","family":"Shimo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nara Medical University  Kashihara Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihito","family":"Tashiro","sequence":"additional","affiliation":[{"name":"Chugai Pharmaceutical Co., Ltd.  Yokohama Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuhiro","family":"Soeda","sequence":"additional","affiliation":[{"name":"Chugai Pharmaceutical Co., Ltd.  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