NCT07439055

Real-World Joint Outcomes After Selective Transition to Low-Dose Emicizumab in Pediatric Hemophilia A

The Study of Clinical Outcomes, Cartilage Biomarkers and Hemophilic Arthropathy (HEAD-US) in Hemophilia A Patients : Low Dose Emicizumab vs. Pharmacokinetic-Guided Extended Half-Life FVIII Concentrates

• Status: Active Not Recruiting
• Phase: Phase 2 / Phase 3
• Study type: Interventional
• Enrollment: 18 (actual)
• Sponsor: Chulalongkorn University · Academic / Other
• Sex: Male
• Age: 3 Years – 30 Years
• Healthy volunteers: Not accepted

Summary

Recent studies have shown that pharmacokinetic (PK)-guided extended half-life (EHL) factor VIII can improve joint health in patients with hemophilia A. However, some patients experience suboptimal joint outcomes despite optimized PK-guided therapy. Low-dose emicizumab has emerged as a potential option for improving bleeding control and joint health in patients who do not respond adequately to PK-guided EHL factor VIII. The objectives of the study is to compare clinical bleeding outcomes, joint health, cartilage biomarkers, and musculoskeletal ultrasound findings (HEAD-US) in hemophilia A patients in Thailand during PK-guided EHL factor VIII therapy and after switching to low-dose emicizumab. Eighteen patients with hemophilia A from King Chulalongkorn Memorial Hospital, Thailand, aged 8-28 years, who were receiving PK-guided EHL factor VIII were enrolled. Patients with a Hemophilia Joint Health Score (HJHS) ≥ 12 were switched to low-dose emicizumab. A loading dose of 2 mcg/kg was administered, followed by dosing every 2 weeks during the first month and every 4 weeks thereafter. Clinical bleeding, annual bleeding rate (ABR), annual joint bleeding rate (AJBR), HJHS, cartilage biomarkers, and musculoskeletal ultrasound findings (HEAD-US) were evaluated every 4 months for up to 8 months after switching.

Conditions

• Hemophilia A Patient

Interventions

Type	Name	Description
DRUG	Switching to low dose emicizumab	All Hemophilia A patients in the study had received treatment with PK-guided EHL factor VIII. The patients who had HJHS more than 12 were switched to treatment with low dose emicizumab

Timeline

• Start date: 2025-06-01
• Primary completion: 2026-03-01
• Completion: 2026-04-01
• First posted: 2026-02-27
• Last updated: 2026-02-27

Locations

1 site across 1 country: Thailand