Background: Emicizumab is a recombinant humanized bispecific monoclonal antibody mimicking the cofactor function of activated factor VIII. It is approved to prevent bleeding in patients with haemophilia A (HA). However, few studies have assessed the safety and efficacy of emicizumab during dental extraction in patients with haemophilia A (HA).

Aims: To systematically review the literature on efficacy and safety of emicizumab during dental extraction in patients with haemophilia A (HA).

Methods: Science direct, Pubmed, Google Scholar, Europe PMC, and Cochrane Library were searched. Searches were performed until December 27, 2021. Snowballing of potential literature was also carried out. The studies included patients with any age with a diagnosis of haemophilia with and without inhibitors. Patients were also required to have received a minimum of four loading doses of emicizumab. All study designs were included in this review.

Results: There were few adverse events were reported in all patients having emicizumab prophylaxis in all procedures, including tooth extraction. Adverse effects most frequently occured in patients with inhibitors. There were no thromboembolic events or thrombotic microangiopathy. All patients experienced minimal blood loss perioperatively. Few patients experienced no treated bleeding events.

Conclusion(s): Evidence are strong enough to determine that emicizumab is effective and safe for patients with haemophilia A during dental extraction.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/safety-and-efficacy-of-emicizumab-during-dental-extraction-in-haemophilia-patient/