Emicizumab and shared medical decision in patients living with hemophilia A

Abstract

AIM: Emicizumab is a new prophylactic treatment for patients with severe hemophilia A. This study evaluated patient decisional conflict and physician decisional comfort regarding the switch to emicizumab, identifying the criteria that drive this choice. METHODS: This is an observational, non-interventional, multicenter, retrospective and exploratory study of hemophilia A patients at seven centers in France. The evaluation used the patient's decisional conflict scale and the physician's decisional comfort scale, as well as a questionnaire to determine the criteria for choosing whether to switch to emicizumab. A cluster approach was applied to identify patient subgroups with distinct decisional profiles. RESULTS: A total of 53 patients and their physicians were included in this study: 34 in the emicizumab arm and 19 in the factor VIII arm. Patients in the factor VIII arm reported higher remorse, while physicians in this group felt significantly less comfortable with the decision. While factors influencing the decision were similar between both patients and physicians, illustrating good mutual understanding. Cluster analysis identified a specific subgroup (23%) in the total cohort experiencing high decisional conflict despite their final choice, highlighting a need for targeted clinical support. CONCLUSION: This study highlights the importance of shared decision-making in hemophilia treatment, encouraging open communication between patients and physicians for more personalized care.

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BibTeX RIS

BibTeX

@article{guillard2026emicizumab,
  title = {{Emicizumab and shared medical decision in patients living with hemophilia A}},
  author = {Nicolas Guillard and Benoit Guillet and Pascal Caillet and Laurent Ardillon and Philippe Beurrier and Vincent Cussac and Brigitte Pan-Petesch and Yoan Repesse and Estelle Leroy and Valérie Horvais and Marc Trossaert and Sonia Prot-Labarthe},
  journal = {Hematology, Transfusion and Cell Therapy},
  year = {2026},
  month = oct,
  doi = {10.1016/j.htct.2026.106504},
  url = {https://hal.science/hal-05778843v1},
  note = {CC BY},
}

RIS

TY  - JOUR
TI  - Emicizumab and shared medical decision in patients living with hemophilia A
AU  - Nicolas Guillard
AU  - Benoit Guillet
AU  - Pascal Caillet
AU  - Laurent Ardillon
AU  - Philippe Beurrier
AU  - Vincent Cussac
AU  - Brigitte Pan-Petesch
AU  - Yoan Repesse
AU  - Estelle Leroy
AU  - Valérie Horvais
AU  - Marc Trossaert
AU  - Sonia Prot-Labarthe
PY  - 2026
DA  - 2026/10/05
JO  - Hematology, Transfusion and Cell Therapy
DO  - 10.1016/j.htct.2026.106504
UR  - https://hal.science/hal-05778843v1
AB  - AIM: Emicizumab is a new prophylactic treatment for patients with severe hemophilia A. This study evaluated patient decisional conflict and physician decisional comfort regarding the switch to emicizumab, identifying the criteria that drive this choice. METHODS: This is an observational, non-interventional, multicenter, retrospective and exploratory study of hemophilia A patients at seven centers in France. The evaluation used the patient's decisional conflict scale and the physician's decisional comfort scale, as well as a questionnaire to determine the criteria for choosing whether to switch to emicizumab. A cluster approach was applied to identify patient subgroups with distinct decisional profiles. RESULTS: A total of 53 patients and their physicians were included in this study: 34 in the emicizumab arm and 19 in the factor VIII arm. Patients in the factor VIII arm reported higher remorse, while physicians in this group felt significantly less comfortable with the decision. While factors influencing the decision were similar between both patients and physicians, illustrating good mutual understanding. Cluster analysis identified a specific subgroup (23%) in the total cohort experiencing high decisional conflict despite their final choice, highlighting a need for targeted clinical support. CONCLUSION: This study highlights the importance of shared decision-making in hemophilia treatment, encouraging open communication between patients and physicians for more personalized care.
SN  - 2531-1379
SN  - 9022-7646
ER  -

Abstract

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