Monitoring of new therapies for hemophilia

Nonreplacement therapies, such as emicizumab (Hemlibra, Roche) and other myriad of molecules are still under study as concizumab (and other anti-TFPI) and fitusiran are transforming the quality of life and treatment of this group of patients. So far, laboratory monitorization has not been an obligate condition for the use of these novel therapies, though in some cases like their combination with bypassing agents to control breakthrough/surgical bleeds may seek for laboratory assays to ensure a well tolerated and effective utilization withing these special scenarios. In the next pages, application of global coagulation assays, for example, thrombinography or rotational thrombelastography will be referred looking to the works of some groups from around the world including our own experience.