The National Hemophilia Foundation’s (NHF’s) Medical and Scientific Advisory Council (MASAC) issued four new documents, which were adopted by NHF’s Board of Directors on February 28, 2020.
MASAC Document #258, which replaces Document #255, represents the most up-to-date information relevant to emicizumab, including a brief description of the therapy and its indications. The document is dedicated to comprehensive guidance to help inform treatment decisions relevant to the use of emicizumab. It includes varied clinical scenarios, and the considerations that providers of hemophilia care should make when weighing the use of emicizumab, such as inhibitor status and management, breakthrough bleeds, surgery, laboratory assays, use of additional therapies. The document also includes a set of standard patient education guidelines, with concrete points of clinician-patient information sharing.
View and download Recommendation on the Use and Management of Emicizumab-kxwh (Hemlibra®) for Hemophilia A with and without Inhibitors.
MASAC Document #259 is the latest version of the council’s enduring and most broad-based treatment document, which includes descriptions of, and recommendations for, the use of all therapies currently approved by the U.S. Food and Drug Administration (FDA) to treat bleeding disorders. This document is accompanied by a list of these therapies, organized by bleeding disorder type. NOTE – The list includes hyperlinks to the FDA webpage dedicated to each approved product.
View and download MASAC Recommendations Concerning Products Licensed for the Treatment of Hemophilia and Other Bleeding Disorders.
MASAC Document #260 was designed as a special supplement to the guidelines issued by the U.S. Centers for Disease Control and Prevention (CDC) in 2016 for prescribing opioids for chronic pain. Created by the Pain Initiative Task Force of MASAC, the document provides guidance for multi-disciplinary healthcare providers who intend to integrate these guidelines into the care of their bleeding disorder patients. The authors highlight special considerations for these patients and share practical advice for effectively managing their chronic pain.
View and download Management of Chronic Pain in Persons with Bleeding Disorders: Guidance for Practical Application of The Centers for Disease Control’s Opioid Prescribing Guidelines.
MASAC Document #261 provides needed guidance on the use of prophylactic therapy in bleeding disorder patients who undergo gastrointestinal (GI) endoscopies, a procedure being employed more frequently to screen for underlying issues such as colorectal cancer. The document includes the baseline risk for GI bleeding by low and high-risk procedures as classified by American Society of Gastrointestinal Endoscopy. The subsequent recommendations lay out the requisite therapeutic target levels to minimize bleeding risk, along with specific guidance on prophylactic dosing for various bleeding and platelet function disorders, considering factors such as disease severity and inhibitor status.
View and download MASAC Recommendations for Bleeding Prophylaxis in Bleeding Disorder Patients Undergoing GI Endoscopy.