Advertisement

Emicizumab use in major orthopedic surgery

Craig D. Seaman and Margaret V. Ragni

Article Figures & Data

Tables

  • Table 1.

    Hip arthroplasty perioperative hemostasis regimen with emicizumab

    TimeSingle doseInterval, h
    36812
    PreoperativeEmicizumab 1.5 mg/kg
    PreoperativerFVIIa 180 μg/kg
    POD 0rFVIIa 90 μg/kg
    POD 1rFVIIa 90 μg/kg
    POD 2rFVIIa 90 μg/kg
    POD 3rFVIIa 90 μg/kg
    POD 4rFVIIa 90 μg/kg
    POD 5rFVIIa 90 μg/kg
    POD 6rFVIIa 90 μg/kg
    POD 7Emicizumab 1.5 mg/kgrFVIIa 90 μg/kg
    POD 8rFVIIa 90 μg/kg
    POD 9rFVIIa 90 μg/kg
    POD 10rFVIIa 90 μg/kg
    POD 11rFVIIa 90 μg/kg
    POD 12rFVIIa 90 μg/kg
    POD 13rFVIIa 90 μg/kg
    POD 14Emicizumab 1.5 mg/kgrFVIIa 90 μg/kg
    • POD, postoperative day.

  • Table 2.

    Knee arthrotomy, synovectomy, and excisional debridement of soft tissue to bone perioperative hemostasis regimen without emicizumab

    TimeSingle doseInterval, h
    3*4612
    PreoperativerFVIIa 180 μg/kg
    POD 0-13rFVIIa 90 μg/kg and APCC 5000 IU
    Preoperative (CVC placement on POD 14)rFVIIa 180 μg/kg
    POD 0-13rFVIIa 90 μg/kg and APCC 5000 IU
    POD 14-27rFVIIa 90 μg/kg and APCC 5000 IU
    POD 28-41rFVIIa 90 μg/kg and APCC 5000 IU
    POD 42-55rFVIIa 90 μg/kg and APCC 5000 IU
    • CVC, central venous catheter.

    • * Interval describes duration between alternating rFVIIa and APCC therapy (ie, rFVIIa alternating with APCC every 3 hours).

    • On POD 14, CVC placement was necessary, so tapering regimen was restarted.

    • After POD 55, regular bypassing agent prophylaxis regimen was resumed.