Evidence map›Paper›PMID 41683793›Full record

ReviewInternational journal of molecular sciences2026

Challenges in Balancing Hemostasis and Thrombosis in Therapy Tailoring for Hemophilia: A Narrative Review.

Gili Kenet, Sarina Levy-Mendelovich, Tami Livnat, Benjamin Brenner

Abstract readReview
In one paragraph

Review in International journal of molecular sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Gili KenetNational Hemophilia Center and Coagulation Institute, Sheba Medical Center, Ramat Gan 52621, Israel.ORCID 0000-0003-3494-9823
Sarina Levy-MendelovichNational Hemophilia Center and Coagulation Institute, Sheba Medical Center, Ramat Gan 52621, Israel.ORCID 0000-0003-3971-0336
Tami LivnatNational Hemophilia Center and Coagulation Institute, Sheba Medical Center, Ramat Gan 52621, Israel.ORCID 0000-0002-1279-2557
Benjamin BrennerDepartment of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa 3109601, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hemostasis and thrombosis reflect a delicate balance, regulated by the interplay between procoagulant and anticoagulant mechanisms. Hemophilia is traditionally viewed as a bleeding disorder, but emerging evidence highlights the paradoxical risks of thrombosis in hemophilia patients. We explore the landscape of hemophilia management, emphasizing challenges of balancing hemostasis in the context of aging, novel non-factor replacement therapies (NRTs), and comorbidity-driven thrombotic complications. Therapeutic approaches, including innovative NRTs, such as emicizumab, or rebalancing agents (e.g., concizumab, marstacimab, fitusiran), offer promising advancements in bleeding prophylaxis but may increase thrombotic risks. Conversely, novel anticoagulants, such as FXI inhibitors, offer potential thrombosis protection with minimal bleeding risk. Our review examines the impact of aging-related comorbidities, including cardiovascular disease, atrial fibrillation, HIV-associated complications, and acute coronary syndromes, on thrombotic risk in hemophilia patients. Evidence-based strategies for balancing hemostasis and thrombosis are outlined alongside experimental models, thrombin generation assays, and advancements in rebalancing coagulation through natural anticoagulant modulation. FXI inhibition emerges as a paradigm shift in thrombosis management, offering reduced bleeding risks while preserving vascular health. Finally, this review highlights the need for global laboratory assays to personalize treatments, emphasizing strategies to optimize safety and efficacy, particularly as hemophilia patients live longer with complex comorbidity profiles.

Indexed as

AnticoagulantsBlood Coagulation FactorsHemophilia AThrombosisAge FactorsAnimalsAntibodies, BispecificAntibodies, Monoclonal, HumanizedHumansAntibodies, BispecificAntibodies, Monoclonal, HumanizedAnticoagulantsBlood Coagulation FactorsemicizumabHemophiliarebalancing agentsthrombosis

Identifiers

PMID41683793
PMCPMC12898652

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.