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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
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Related Experiment Video

Updated: Jun 29, 2025

Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice
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Predictive parameters for spontaneous joint bleeding during emicizumab prophylaxis.

Sara Arcudi1, Roberta Gualtierotti1,2, Erica Scalambrino1

  • 1Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy.

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Summary

Joint health scores, not lab tests, can predict spontaneous bleeding in hemophilia A patients on emicizumab. Synovitis and higher HEAD-US scores identify those at increased risk.

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Area of Science:

  • Hematology
  • Coagulation Disorders
  • Pharmacology

Background:

  • Emicizumab prophylaxis is effective for hemophilia A (HA) but doesn't eliminate all bleeding events.
  • A need exists for tools to identify HA patients on emicizumab at risk for spontaneous joint bleeding.

Purpose of the Study:

  • To evaluate if laboratory markers or arthropathy scores predict spontaneous joint bleeding in HA patients receiving emicizumab.

Main Methods:

  • Observational cohort study of 40 severe HA patients on emicizumab.
  • Assessed global coagulation assays, emicizumab levels, Hemophilia Joint Health Score, and HEAD-US score.
  • Used Cox regression and ROC analysis to identify predictors of spontaneous joint bleeding.

Main Results:

  • No laboratory parameters predicted spontaneous joint bleeding.
  • Synovitis and higher HEAD-US scores were significantly associated with increased bleeding risk (AUC=0.84).

Conclusions:

  • Joint assessment scores, specifically synovitis and HEAD-US, can predict spontaneous joint bleeding in HA patients on emicizumab prophylaxis.
  • Laboratory markers are insufficient for risk stratification in this population.