Oct 2, 2026 · 14 min · 9 segments
In episode 3 of this ISTH Pulse Podcast miniseries, experts explore why next-generation mimetic therapies may be needed in hemophilia A and what they could add to an already evolving treatment…
Jeffrey WeitzGuest
Geoffrey BarnesHost
Mike SharmaGuest
Deborah SiegelGuest
Yeah, and I think that brings us around to this last sort of part here is you're all experts in your field, studying these drugs, specialized care.
Practicing clinicians, what do they need to know? Maybe one kind of thought from each of you as we sort of come to a close.
I think they need to know first that this is a new medication that is directed toward patients who have non-cardiobolic stroke.
They have to know what does it do, how does it work, and how do they manage the potential complications, not from the drug itself, but complications that the patient experienced.
And I don't think we should forget the potential role of pharmacists in this because patients are going to go into the pharmacy to renew their prescriptions and the pharmacist has a teaching moment there to impress upon the patient the importance of continuing the therapy.
And the fact, Mike, that this does not increase the risk of minor bleeding or nuisance bleeding is good because it's often those nuisance bleeds that lead patients to stop therapy.
I think that knowledge has to be dispersed quite widely so that the patient receives the same message from all of the healthcare practitioners they're seeing.
One big fear is premature discontinuation, and as a result, patients are exposed to increased risk.
One of the concerns we have is people will overreact to things like the elevated PTT.
When you withdraw the medication, you expose that patient once again to a risk of recurrent stroke.
And stroke recurrence is associated with high mortality and high morbidity, which we really want to avoid.
And I think for the cardiovascular specialists, we really need to be present to support the acute phase with the stroke neurologists who are often going to be the ones initiating.
But we need to be there to make sure that the family physicians, the primary care physicians, they have questions.
When the patients have questions, that they know that they can come to us and say, how does this fit in? How does this fit into the larger cardiovascular risk factor modification we're doing with blood pressure, with lipids, with antithrombotic agents, understanding how they may or may not contribute to bleeding and not overreacting to stop drugs right away.
We really need to understand how this fits and how it's different from the current DOACs so that we're not treating it in the same way.
Yeah, and I think that brings us around to this last sort of part here is you're all experts in your field, studying these drugs, specialized care.
Practicing clinicians, what do they need to know? Maybe one kind of thought from each of you as we sort of come to a close.
I think they need to know first that this is a new medication that is directed toward patients who have non-cardiobolic stroke.
They have to know what does it do, how does it work, and how do they manage the potential complications, not from the drug itself, but complications that the patient experienced.
And I don't think we should forget the potential role of pharmacists in this because patients are going to go into the pharmacy to renew their prescriptions and the pharmacist has a teaching moment there to impress upon the patient the importance of continuing the therapy.
And the fact, Mike, that this does not increase the risk of minor bleeding or nuisance bleeding is good because it's often those nuisance bleeds that lead patients to stop therapy.
I think that knowledge has to be dispersed quite widely so that the patient receives the same message from all of the healthcare practitioners they're seeing.
One big fear is premature discontinuation, and as a result, patients are exposed to increased risk.
One of the concerns we have is people will overreact to things like the elevated PTT.
When you withdraw the medication, you expose that patient once again to a risk of recurrent stroke.
And stroke recurrence is associated with high mortality and high morbidity, which we really want to avoid.
And I think for the cardiovascular specialists, we really need to be present to support the acute phase with the stroke neurologists who are often going to be the ones initiating.
But we need to be there to make sure that the family physicians, the primary care physicians, they have questions.
When the patients have questions, that they know that they can come to us and say, how does this fit in? How does this fit into the larger cardiovascular risk factor modification we're doing with blood pressure, with lipids, with antithrombotic agents, understanding how they may or may not contribute to bleeding and not overreacting to stop drugs right away.
We really need to understand how this fits and how it's different from the current DOACs so that we're not treating it in the same way.
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