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Updated: Feb 9, 2026

Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
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Shifting Landscape of Hemophilia Therapy: Implications for Current Clinical Laboratory Coagulation Assays

Hanny Al-Samkari1,2, Stacy E Croteau3,2

  • 1Center for Hematology, Massachusetts General Hospital Cancer Center, Boston, MA.

American Journal of Hematology
|June 10, 2018
PubMed

Clinical coagulation assays are an integral part of diagnosing and managing patients with hemophilia; however, in this new era of bioengineered factor products and non-factor therapeutics, problems have arisen with use of traditional coagulation tests for the quantification of several of these new products. Discussion over the use of one-stage clotting assays versus chromogenic substrate assays for clinical decision making and potency labeling has been ongoing for many years. Emerging factor concentrates have heightened concern over assay selection and availability. Emicizumab interferes with all aPTT based assays, rendering them unreliable and potentially falsely reassuring to the unaware provider. This review explores considerations for coagulation assays in the clinical setting and highlights how awareness of institutional coagulation assays and potential limitations have never been more critical for providers caring for patients with bleeding disorders. This article is protected by copyright. All rights reserved.

Keywords:
Coagulation Factor Replacement therapiesHemophiliachromogenic substrate assayextended half-life productsone stage clotting assay

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