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Peer-reviewedCC BYResearch and practice in thrombosis and haemostasis

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

  • Yoko Mizoguchi1
  • Maiko Shimomura1
  • Yuko Teraoka2
  • Teruhisa Fujii3
  • Satoshi Okada1
  1. 1Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
  2. 2Department of Obstetrics and Gynecology, Hiroshima University Hospital, Hiroshima, Japan.
  3. 3Division of Transfusion Medicine, Hemophilia Treatment Center, Hiroshima University Hospital, Hiroshima, Japan.
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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.

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Cite

BibTeXRIS
BibTeX
@article{mizoguchi2026concizumab,
  title = {{Concizumab for the management of heavy menstrual bleeding in a woman with mild hemophilia A.}},
  author = {Yoko Mizoguchi and Maiko Shimomura and Yuko Teraoka and Teruhisa Fujii and Satoshi Okada},
  journal = {Research and practice in thrombosis and haemostasis},
  year = {2026},
  month = sep,
  doi = {10.1016/j.rpth.2026.106979},
  url = {https://europepmc.org/article/MED/42926933},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Concizumab for the management of heavy menstrual bleeding in a woman with mild hemophilia A.
AU  - Yoko Mizoguchi
AU  - Maiko Shimomura
AU  - Yuko Teraoka
AU  - Teruhisa Fujii
AU  - Satoshi Okada
PY  - 2026
DA  - 2026/09/24
JO  - Research and practice in thrombosis and haemostasis
DO  - 10.1016/j.rpth.2026.106979
UR  - https://europepmc.org/article/MED/42926933
AB  - 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.
SN  - 2475-0379
ER  -