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Hemostatic Rebalancing in Hemophilia

CE / CME

Clinical Focus in Hemophilia: Integrating Hemostatic Rebalancing Therapies Into Personalized, Evidence-Based Patient Care

ABIM MOC: maximum of 0.75 Medical Knowledge MOC point

Physicians: Maximum of 0.75 AMA PRA Category 1 Credit

Released: March 16, 2026

Expiration: September 15, 2026

Activity

Progress
1 2 3
Course Completed

Introduction

In this module, Angela Weyand, MD, and Guy Young, MD, discuss rebalancing agents indicated for use in hemophilia. Specifically, they review the mechanism of action, clinical trials, efficacy, and safety leading to the approval of concizumab, fitusiran, and marstacimab, and provide practical insights on the use of these therapies for your patients.

The key points discussed in this module are illustrated with thumbnails from the accompanying downloadable PowerPoint slideset, which can be found here or downloaded by clicking on any of the slide thumbnails in the module alongside the expert commentary. 

Please note that Decera Clinical Education plans to measure the educational impact of this activity. Some questions will be asked twice: once at the beginning of the activity, and once again after the discussion that informs the best choice. Your responses will be aggregated for analysis, and your individual responses will not be shared. Thank you in advance for helping us assess the impact of this education.

Before continuing with this educational activity, please take a moment to answer the following questions.

How many people with hemophilia do you provide care for in a typical month?

For those who practice in academic or community settings, please indicate your practice setting:

When reviewing prophylaxis options with a 15‑year‑old who has severe hemophilia B with no history of inhibitors, his family asks whether fitusiran is an appropriate choice. What would you tell them is the approved indication of fitusiran for routine prophylaxis?

How confident are you in your answer?

A 17‑year‑old with severe hemophilia A without inhibitors is discussing alternative prophylaxis options with you. He and his family want to understand why rebalancing agents may help control bleeding, particularly how these agents correct the underlying hemostatic defect. What is an appropriate point to include during your discussion?

How confident are you in your answer?

A 28‑year‑old man with severe hemophilia A and a high‑titer inhibitor is scheduled for an elective ankle arthroplasty in 6 weeks. He prefers subcutaneous prophylaxis, and you anticipate that a short pharmacologic washout would be helpful around surgery. Which rebalancing option is the most appropriate for this patient? 

How confident are you in your answer?

A patient with hemophilia B and an inhibitor is initiated on subcutaneous fitusiran prophylaxis. You are developing his long-term management plan to ensure efficacy and mitigate safety risks. Which monitoring strategy is required to minimize the risk of thromboembolism in this patient?

How confident are you in your answer?