Products
Emicizumab was approved in the United States in 2017 and in the EU and many countries in 2018 as a subcutaneous solution for injection (Hemlibra).
Structure and properties
Emicizumab is a humanized and modified bispecific IgG4 monoclonal antibody that binds Factor IXa and Factor X. It is a human antibody. It has a molecular mass of 145.6 kDa and is produced by biotechnolgical methods.
Effects
By simultaneously binding factor IXa and factor X, emicizumab (ATC B02BX) takes over the function of the missing factor VIII, which is required for blood clotting. This enables the formation of factor Xa, thrombin and fibrin. The median half-life is 27.8 days.
Indications
For the prevention of bleeding episodes in patients with:
- Hemophilia A (congenital factor VIII deficiency) with factor VIII inhibitors,
- Severe hemophilia A (congenital factor VIII deficiency, FVIII <1%) without factor VIII inhibitors.
Dosage
According to the professional information. The drug is usually injected subcutaneously once a week, the interval can be extended individually up to 4 weeks.
Contraindications
- Hypersensitivity
For complete precautions, see the drug label.
Adverse effects
The most common potential adverse effects include injection site reactions, headache, and joint pain. Because emicizumab has no structural similarity to factor VIII, inhibitors against FVIII are not formed during therapy.
