{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:10:46Z","timestamp":1777479046229,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Karolinska Institute Foundation for Coagulation Research","award":["Karolinska Institute Foundation for Coagulation Re"],"award-info":[{"award-number":["Karolinska Institute Foundation for Coagulation Re"]}]},{"name":"Arosenius fond","award":["Arosenius fond"],"award-info":[{"award-number":["Arosenius fond"]}]},{"DOI":"10.13039\/100008373","name":"Takeda Pharmaceutical Company","doi-asserted-by":"publisher","award":["IIR-SWE-BXLT-001972\/ IISR-2017-104237"],"award-info":[{"award-number":["IIR-SWE-BXLT-001972\/ IISR-2017-104237"]}],"id":[{"id":"10.13039\/100008373","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>For patients with hemophilia A and high-titer inhibitors treated with bypassing agents there are no reliable methods to assess treatment effect. We investigated the utility of global hemostatic methods in assessing treatment with bypassing agents (rFVIIa or activated prothrombin complex [aPCC]). All patients with hemophilia A and inhibitors followed at the Coagulation Unit or the Pediatric Coagulation Unit at Karolinska University Hospital aged 6 years and above were eligible for this noninterventional study. Baseline plasma samples were spiked with bypassing agents in increasing concentrations (aPCC 50 U\/kg, 100 U\/kg, 150 U\/kg, and rFVIIa 90 \u03bcg\/kg and 270 \u03bcg\/kg) in vitro. For patients treated with factor concentrates or bypassing agents follow-up samples were collected (in vivo tests). The samples were analyzed using overall hemostatic potential (OHP), and calibrated automated thrombogram, Calibrated Automated Thrombogram (CAT). Nine patients with hemophilia A with inhibitors were included. Spiking with rFVIIa normalized the coagulation potential in 6\/8 samples, in 3 only with high dose. Only one sample did not improve adequately after spiking with aPCC. The improvement in hemostasis was reliably shown by both CAT and OHP. The baseline potential was, however, more often measurable by OHP compared to CAT. Factor concentrate had been administered to 5 patients normalizing the hemostatic potential in vivo in 2 (without spiking). The hemostatic improvement induced by spiking with rFVIIa or aPCC is shown by OHP and CAT, but the results have to be evaluated in larger cohorts.<\/jats:p>","DOI":"10.1177\/10760296241260053","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T07:10:15Z","timestamp":1721891415000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Global Hemostatic Methods to Tailor Treatment With Bypassing Agents in Hemophilia A With Inhibitors\u2014 A Single-Center, Pilot Study"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9069-1903","authenticated-orcid":false,"given":"Roza","family":"Chaireti","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"},{"name":"Coagulation Unit, Department of Haematology, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nida","family":"Soutari","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"},{"name":"Clinical Chemistry, Medical Diagnostics, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margareta","family":"Holmstr\u00f6m","sequence":"additional","affiliation":[{"name":"Coagulation Unit, Department of Haematology, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Health, Medicine and Caring Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pia","family":"Petrini","sequence":"additional","affiliation":[{"name":"Pediatric Coagulation Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Magnusson","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"},{"name":"Coagulation Unit, Department of Haematology, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Pediatric Coagulation Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Ranta","sequence":"additional","affiliation":[{"name":"Pediatric Coagulation Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iva","family":"Pruner","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jovan P.","family":"Antovic","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"},{"name":"Clinical Chemistry, Medical Diagnostics, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"key":"bibr1-10760296241260053","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12672"},{"key":"bibr2-10760296241260053","doi-asserted-by":"crossref","DOI":"10.1111\/j.1365-2516.2012.02909.x","volume":"19","author":"Srivastava A","year":"2013","journal-title":"Haemophilia"},{"key":"bibr3-10760296241260053","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V99.7.2337"},{"key":"bibr4-10760296241260053","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2006.01772.x"},{"key":"bibr5-10760296241260053","first-page":"49","volume":"31","author":"Lusher JM.","year":"1994","journal-title":"Semin Hematol"},{"key":"bibr6-10760296241260053","first-page":"4303","volume":"10","author":"Levy-Mendelovich S","year":"2021","journal-title":"Clin 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