Work

Concizumab for the management of heavy menstrual bleeding in a woman with mild hemophilia A

Year: 2026

Type: article

Abstract: Background: Heavy menstrual bleeding (HMB) is a common bleeding manifestation in women with hemophilia A and may impair quality of life. Key Clinical Question: Can concizumab control refractory HMB in a woman with mild hemophilia A who cannot tolerate conventional therapies? Clinical Approach: An 18-year-old woman with mild hemophilia A had prolonged menstruation. Combined oral contraceptives improved bleeding but were discontinued because of mood-related adverse effects. Extended half-life factor (F)VIII concentrates shortened menstruation but caused significant burden due to repeated venipuncture. Following shared decision making, subcutaneous concizumab was initiated. During concizumab treatment, menstrual duration was generally maintained at 7 to 11 days per cycle. Menstrual control deteriorated after temporary concizumab dose reduction and remained inadequate despite the addition of tranexamic acid, prompting restoration of the previous concizumab dose. Subsequent concizumab concentration and D-dimer levels were within their respective target or reference ranges. Conclusions: Concizumab provided menstrual bleeding control broadly comparable with intravenous FVIII replacement while reducing treatment burden. This single case does not establish concizumab as a treatment for HMB in women with mild hemophilia A, but its potential role in carefully selected patients warrants further investigation.

Source: Research and Practice in Thrombosis and Haemostasis

DOI: 10.1016/j.rpth.2026.106979

Authors: Yoko Mizoguchi, Maiko Shimomura, Yuko Teraoka, Teruhisa Fujii, Satoshi Okada

Institutions: Hiroshima University, Hiroshima University Hospital

Language: English

Topic: Hemophilia Treatment and Research

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,250