Journal of Thrombosis and Haemostasis最新文献

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Ambient Temperature, Air Pollutants and Pulmonary Embolism Onset: A 17-Year Nationwide Study in China. 环境温度、空气污染物与肺栓塞发病:中国一项为期17年的全国性研究。
IF 5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2026-05-07 DOI: 10.1016/j.jtha.2026.04.020
Lu Zhou, Mengjie Duo, Bingzhang Zou, Zhu Zhang, Hong Chen, Yuanhua Yang, Jun Wan, Xiaomao Xu, Yingqun Ji, Guoru Yang, Ping Zhang, Jing Han, Kejing Ying, Qixia Xu, Ling Zhu, Yingyun Fu, Qin Luo, Haobo Li, Dingyi Wang, Yunxia Zhang, Shuai Zhang, Qiang Huang, Wanmu Xie, Haidong Kan, Zhenguo Zhai
{"title":"Ambient Temperature, Air Pollutants and Pulmonary Embolism Onset: A 17-Year Nationwide Study in China.","authors":"Lu Zhou, Mengjie Duo, Bingzhang Zou, Zhu Zhang, Hong Chen, Yuanhua Yang, Jun Wan, Xiaomao Xu, Yingqun Ji, Guoru Yang, Ping Zhang, Jing Han, Kejing Ying, Qixia Xu, Ling Zhu, Yingyun Fu, Qin Luo, Haobo Li, Dingyi Wang, Yunxia Zhang, Shuai Zhang, Qiang Huang, Wanmu Xie, Haidong Kan, Zhenguo Zhai","doi":"10.1016/j.jtha.2026.04.020","DOIUrl":"https://doi.org/10.1016/j.jtha.2026.04.020","url":null,"abstract":"<p><strong>Background: </strong>The short-term effects of ambient temperature and air pollution interaction on pulmonary embolism (PE) onset remain a critical public health concern. Evidence from large-scale, multicenter studies is limited.</p><p><strong>Objectives: </strong>To quantify the associations of ambient temperature, fine particulate matter (PM<sub>2.5</sub>), nitrogen dioxide (NO<sub>2</sub>), and ozone (O<sub>3</sub>) with PE onset in China.</p><p><strong>Methods: </strong>We conducted a nationwide time-stratified case-cross over analysis of 48,589 PE cases from hospital-based registries across China (2005-2021). Meteorological data were obtained from fixed-site monitoring stations. PM<sub>2.5</sub>, NO<sub>2</sub>, and O<sub>3</sub> concentrations were assessed using high-resolution satellite-based models. Conditional logistic regression models were used to estimate the effects.</p><p><strong>Results: </strong>Ambient low temperature significantly increased PE onset risk, with an odds ratio (OR) of 1.47 (95% CI: 1.19-1.80) at extreme low temperature (-11.6°C) compared to the reference (23.4°C). At lag 0 day, each 10 μg/m<sup>3</sup> increase in NO<sub>2</sub> was significantly associated with PE onset (OR = 1.011, 95% CI: 1.003-1.018). PM<sub>2.5</sub> showed a weaker effect (OR = 1.004), while O3 showed no significant association. Significant pollutant effects were observed exclusively during the warm season. NO<sub>2</sub> remained significantly associated with PE onset despite overall air quality improvement after 2014.</p><p><strong>Conclusion: </strong>Ambient low temperature, NO<sub>2</sub>, and PM<sub>2.5</sub> significantly elevate PE onset risk. China's air quality improvement reduced the health risk of PM<sub>2.5</sub> but not NO<sub>2</sub>. PE prevention should prioritize targeted NO<sub>2</sub> emission control alongside climate-adapted measures.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ADAMTS13 and von Willebrand Factor in relation to vascular cognitive impairment and cerebral small vessel disease: the Heart-Brain Connection Study. ADAMTS13和血管性认知障碍和脑小血管疾病相关的血管性血友病因子:心脑连接研究
IF 5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2026-05-07 DOI: 10.1016/j.jtha.2026.04.022
Amos C Pomp, Mathijs T Rosbergen, Moniek P M de Maat, Paul S de Vries, M Arfan Ikram, Mat J A P Daemen, Imo E Hoefer, Wiro J Niessen, Jeroen de Bresser, Esther E Bron, Charlotte E Teunissen, Geert Jan Biessels, Robert J van Oostenbrugge, Frank J Wolters
{"title":"ADAMTS13 and von Willebrand Factor in relation to vascular cognitive impairment and cerebral small vessel disease: the Heart-Brain Connection Study.","authors":"Amos C Pomp, Mathijs T Rosbergen, Moniek P M de Maat, Paul S de Vries, M Arfan Ikram, Mat J A P Daemen, Imo E Hoefer, Wiro J Niessen, Jeroen de Bresser, Esther E Bron, Charlotte E Teunissen, Geert Jan Biessels, Robert J van Oostenbrugge, Frank J Wolters","doi":"10.1016/j.jtha.2026.04.022","DOIUrl":"https://doi.org/10.1016/j.jtha.2026.04.022","url":null,"abstract":"<p><strong>Background: </strong>Reduced activity of a disintegrin-like and metalloprotease with thrombospondin type 1 repeats 13 (ADAMTS13) is associated with an increased risk of dementia, independent of Von Willebrand Factor levels (VWF). Pathways underlying this association remain poorly understood.</p><p><strong>Objectives: </strong>Investigate the associations of VWF levels and ADAMTS13 activity with vascular cognitive impairment (VCI) and cerebral small vessel disease (CSVD).</p><p><strong>Methods: </strong>In this cross-sectional study, we included 147 participants with VCI and 120 reference subjects (mean age:67.5 years,41% women). Using multivariable logistic regression, we determined the cross-sectional association of ADAMTS13 activity and VWF levels in plasma with VCI. Additionally, across cases and reference subjects combined, we determined the cross-sectional association of VWF and ADAMTS13 with markers of CSVD on 3T brain MRI.</p><p><strong>Results: </strong>Participants with lower ADAMTS13 activity had a higher odds of VCI (OR per 1-SD decrease:1.46 [95%CI:1.04-2.04), whereas participants with higher VWF levels did not (OR per 1-SD increase:1.15 [95%CI:0.85-1.56]). Overall, lower ADAMTS13 and higher VWF were similarly associated with higher white matter hyperintensity volume (mean difference per 1-SD change in ADAMTS13:0.12 [95%CI:-0.01-0.25, and for VWF:0.13 [95%CI:0.01-0.26). For microbleeds, lacunes and microinfarcts, low ADAMTS13 and high VWF showed ORs of around 2 for the utmost quartiles, which was statistically significant only for VWF and lacunes. We found no evidence of synergistic effects of ADAMTS13 and VWF.</p><p><strong>Conclusions: </strong>Low ADAMTS13 activity is associated with VCI, independent of concurrently measured VWF. Low ADAMTS13 activity and high VWF levels are associated with markers of CSVD.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Designing Biomarker-selected International Trials in Sepsis-Associated Coagulopathy. 设计败血症相关凝血病的生物标志物选择国际试验。
IF 5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2026-05-07 DOI: 10.1016/j.jtha.2026.04.023
Toshiaki Iba, Julie Helms, Jerrold H Levy
{"title":"Designing Biomarker-selected International Trials in Sepsis-Associated Coagulopathy.","authors":"Toshiaki Iba, Julie Helms, Jerrold H Levy","doi":"10.1016/j.jtha.2026.04.023","DOIUrl":"https://doi.org/10.1016/j.jtha.2026.04.023","url":null,"abstract":"<p><p>Sepsis-associated coagulopathy represents a dynamic thromboinflammatory continuum ranging from early, compensated sepsis-induced coagulopathy (SIC) to overt disseminated intravascular coagulation (DIC). Divergent international strategies reflect differences in cohort selection, timing of intervention, and outcome prioritization rather than fundamental biological disagreement. Large randomized trials conducted in unselected sepsis populations have often yielded neutral results, likely due to biological heterogeneity and temporal signal dilution. We propose GLOBAL-SIC/DIC, a pragmatic international registry designed to support biomarker-selected interventional trials. The framework incorporates: (1) early stratification of SIC and overt DIC at enrollment; (2) harmonized serial sampling windows using a minimal, globally feasible core coagulation panel; and (3) a prespecified hierarchical composite endpoint analyzed using the win ratio. The proposed hierarchy prioritizes 28-day mortality, major bleeding, clinically relevant thrombosis, DIC resolution, and organ dysfunction trajectory. This structure integrates survival, safety, and biologically proximal response measures within a single analytic framework. Expanded mechanistic biomarkers, including markers of endothelial injury, complement activation, and fibrinolytic dysregulation, are confined to central-laboratory substudies to preserve operational feasibility. By combining biological enrichment, temporal fidelity, and safety-aware endpoint design, GLOBAL-SIC/DIC provides a scalable platform for registry-to-randomized trial translation. This methodological convergence aligns early-intervention principles with international safety expectations and supports precision phenotyping in future global research on sepsis-associated coagulopathy.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incident venous thromboembolism in biopsy-proven metabolic dysfunction-associated steatotic liver disease: a nationwide cohort study. 活检证实的代谢功能障碍相关脂肪变性肝病的静脉血栓栓塞:一项全国性队列研究
IF 5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2026-05-06 DOI: 10.1016/j.jtha.2026.04.019
Shuai Yuan, Fahim Ebrahimi, Anders Forss, Jiangwei Sun, Bengt Zöller, Hannes Hagström, Jonas F Ludvigsson
{"title":"Incident venous thromboembolism in biopsy-proven metabolic dysfunction-associated steatotic liver disease: a nationwide cohort study.","authors":"Shuai Yuan, Fahim Ebrahimi, Anders Forss, Jiangwei Sun, Bengt Zöller, Hannes Hagström, Jonas F Ludvigsson","doi":"10.1016/j.jtha.2026.04.019","DOIUrl":"https://doi.org/10.1016/j.jtha.2026.04.019","url":null,"abstract":"<p><strong>Background: </strong>The absolute and relative risk of venous thromboembolism (VTE) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) remains largely unexplored. We conducted a nationwide cohort study to explore this.</p><p><strong>Methods: </strong>This nationwide, population-based matched cohort study in Sweden included all individuals with biopsy-confirmed MASLD (1965-2017). MASLD was histologically classified into simple steatosis, metabolic dysfunction-associated steatohepatitis (MASH), non-cirrhotic fibrosis, and cirrhosis. Each MASLD case was matched to up to five general population comparators. VTE events were identified using the Swedish National Patient Register up until 2021.</p><p><strong>Results: </strong>We included 11,073 individuals with MASLD and 50,078 comparators. During a median follow-up of 18.6 years., incident VTE occurred in 1,291 patients with MASLD and 4,067 comparators. The incidence rate of VTE was higher in MASLD (7.6 vs. 3.4 per 1,000 person-years), yielding an adjusted hazard ratio (aHR) of 1.78 (95%CI: 1.65-1.91). The absolute risk difference was 3.9 per 1,000 person-years, equating to 1 extra VTE per 26 patients with MASLD over 10 years. MASLD was associated with a higher incidence of VTE triggered by cancer, hospitalization, and surgery. Higher aHRs were observed in women compared to men, and in patients with baseline cancer or metabolic disorders compared to those without. The risk of portal vein thrombosis (PVT) was markedly elevated (aHR=3.40; 95%CI: 2.93-3.95), increasing progressively with MASLD severity (P=0.003). Findings were similar when siblings were used as comparators to account for intrafamilial confounding.</p><p><strong>Conclusions: </strong>Biopsy-confirmed MASLD was associated with a higher incidence of VTE, particularly PVT.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The road to Paris: ISTH 2026 Congress set to debut the latest science and innovation. 通往巴黎之路:ISTH 2026大会将首次展示最新的科学和创新。
IF 5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2026-05-02 DOI: 10.1016/j.jtha.2026.04.018
Walter Ageno, Françoise Dignat-George, Cihan Ay
{"title":"The road to Paris: ISTH 2026 Congress set to debut the latest science and innovation.","authors":"Walter Ageno, Françoise Dignat-George, Cihan Ay","doi":"10.1016/j.jtha.2026.04.018","DOIUrl":"https://doi.org/10.1016/j.jtha.2026.04.018","url":null,"abstract":"","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The MAPTO survey: worldwide approaches on unmasking factor VIII inhibitors in children with emicizumab treatment: communication from the ISTH SSC Subcommittee on Factor VIII, Factor IX and Rare Coagulation Disorders MAPTO调查:在接受Emicizumab治疗的儿童中揭示因子VIII抑制剂的全球方法:来自ISTH SSC因子VIII,因子IX和罕见凝血障碍小组委员会的交流。
IF 5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2026-05-01 Epub Date: 2026-02-03 DOI: 10.1016/j.jtha.2026.01.006
Lilianne Esmée van Stam , Bridget Jane Daisy Horstman , Pantep Angchaisuksiri , Manuel Carcao , Gili Kenet , Christoph Königs , Johnny Mahlangu , Maria Elisa Mancuso , Suely Meireles Rezende , Robert Francis Sidonio Jr. , Alok Srivastava , Guy Young , Karin Fijnvandraat , Samantha Claudia Gouw
{"title":"The MAPTO survey: worldwide approaches on unmasking factor VIII inhibitors in children with emicizumab treatment: communication from the ISTH SSC Subcommittee on Factor VIII, Factor IX and Rare Coagulation Disorders","authors":"Lilianne Esmée van Stam ,&nbsp;Bridget Jane Daisy Horstman ,&nbsp;Pantep Angchaisuksiri ,&nbsp;Manuel Carcao ,&nbsp;Gili Kenet ,&nbsp;Christoph Königs ,&nbsp;Johnny Mahlangu ,&nbsp;Maria Elisa Mancuso ,&nbsp;Suely Meireles Rezende ,&nbsp;Robert Francis Sidonio Jr. ,&nbsp;Alok Srivastava ,&nbsp;Guy Young ,&nbsp;Karin Fijnvandraat ,&nbsp;Samantha Claudia Gouw","doi":"10.1016/j.jtha.2026.01.006","DOIUrl":"10.1016/j.jtha.2026.01.006","url":null,"abstract":"<div><div>It might take years for previously untreated patients (PUPs) with hemophilia A on emicizumab prophylaxis to receive 50 factor VIII (FVIII) exposures. This corresponds to the time at risk for FVIII inhibitors under conventional FVIII prophylaxis. During emicizumab prophylaxis, it is unknown whether additional treatment with regular FVIII doses promotes FVIII tolerance, unmasks inhibitors, or rather, induces them. Therefore, we conducted a survey to describe the current global perspectives and practices of hemophilia health care providers (HCPs) in PUPs with severe hemophilia A receiving emicizumab prophylaxis. In 2024, a survey was sent by email to 1193 hemophilia treatment centers, addressing the perceived inhibitor risk with emicizumab, the potential need for concomitant regular FVIII infusions, and the perceived parental willingness to use concomitant FVIII. In total, 102 pediatric HCPs (85% physicians, 13% nurses) from 38 countries participated. Perceived inhibitor risk data were available for 63 HCPs (62%). Compared with FVIII prophylaxis, the inhibitor risk on emicizumab was estimated to be higher by 13%, equal by 41%, lower by 32%, and unknown by 14%. Among 57 of 102 HCPs with clinical access to emicizumab for children with severe hemophilia A without inhibitors, 30 (53%) offered regular concomitant FVIII infusions. However, in the experience of the HCPs, approximately 45% of parents rejected this option due to concerns about intravenous access. Ultimately, global perspectives on FVIII inhibitor risk and concomitant FVIII use in PUPs on emicizumab prophylaxis are heterogeneous due to lack of evidence, indicating the need for further research to guide treatment strategies.</div></div>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":"24 5","pages":"Pages 1886-1895"},"PeriodicalIF":5.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genetically predicted mannose-binding lectin levels and risk of future venous thromboembolism—the HUNT Study 遗传预测甘露糖结合凝集素(MBL)水平和未来静脉血栓栓塞的风险- HUNT研究。
IF 5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2026-05-01 Epub Date: 2026-02-13 DOI: 10.1016/j.jtha.2026.01.028
Christabel Esi Damoah , Birgitte Tøndel , Omri Snir , Peter Garred , Tom Eirik Mollnes , Kristian Hveem , Steven P. Grover , Kristian Dalsbø Hindberg , Sigrid K. Brækkan , John-Bjarne Hansen
{"title":"Genetically predicted mannose-binding lectin levels and risk of future venous thromboembolism—the HUNT Study","authors":"Christabel Esi Damoah ,&nbsp;Birgitte Tøndel ,&nbsp;Omri Snir ,&nbsp;Peter Garred ,&nbsp;Tom Eirik Mollnes ,&nbsp;Kristian Hveem ,&nbsp;Steven P. Grover ,&nbsp;Kristian Dalsbø Hindberg ,&nbsp;Sigrid K. Brækkan ,&nbsp;John-Bjarne Hansen","doi":"10.1016/j.jtha.2026.01.028","DOIUrl":"10.1016/j.jtha.2026.01.028","url":null,"abstract":"<div><h3>Background</h3><div>Elevated plasma mannose-binding lectin (MBL) levels are associated with increased risk of venous thromboembolism (VTE). Although MBL levels are affected by environmental factors, it is mainly genetically regulated.</div></div><div><h3>Objectives</h3><div>We aimed to investigate the association between genetically predicted MBL and VTE risk in a population-based cohort.</div></div><div><h3>Methods</h3><div>The study comprised 68 999 individuals from the Trøndelag Health Study (HUNT). Six genetic variants were used to classify individuals in low, medium, and high genetically predicted MBL. Linear regression was applied to estimate whether genetically predicted MBL explained plasma variability of MBL. Cox regression was used to estimate hazard ratios (HRs) with 95% CIs for VTE across genetically predicted MBL categories stratified by sex (men and women) and age groups (reference: low category).</div></div><div><h3>Results</h3><div>There were 2043 incident VTEs during 12 years’ median follow-up. Genetically predicted MBL explained 52.8% of the plasma variability of MBL, and women had lower plasma MBL than men. Genetically predicted MBL was associated with a significantly increased risk of VTE in individuals &lt;60 to 65 years and displayed sex differences. In sex- and age-stratified analysis, men &lt;50 years with high genetically predicted MBL had elevated risk of overall VTE (HR, 2.13; 95% CI, 1.27-3.55), unprovoked VTE (HR, 2.87; 95% CI, 1.28-6.43), and pulmonary embolism (HR, 2.66; 95% CI, 1.11-6.33). In older men and in women, no associations were found.</div></div><div><h3>Conclusion</h3><div>We found a moderate association between genetically predicted MBL and VTE in young- and middle-aged men. Sex differences and accumulation of environmental factors with age might preclude associations in older men and in women.</div></div>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":"24 5","pages":"Pages 1792-1804"},"PeriodicalIF":5.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Caplacizumab resistance in immune thrombotic thrombocytopenic purpura is associated with a von Willebrand factor A1 domain missense variant 与VWF A1结构域错义变异相关的免疫性血栓性血小板减少性紫癜(iTTP)的卡普单抗耐药
IF 5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2026-05-01 Epub Date: 2026-02-13 DOI: 10.1016/j.jtha.2026.01.023
Mari Thomas , Imogen Buckle , Adela Constantinescu-Bercu , Rens De Groot , Sabina McCann , Marie Scully
{"title":"Caplacizumab resistance in immune thrombotic thrombocytopenic purpura is associated with a von Willebrand factor A1 domain missense variant","authors":"Mari Thomas ,&nbsp;Imogen Buckle ,&nbsp;Adela Constantinescu-Bercu ,&nbsp;Rens De Groot ,&nbsp;Sabina McCann ,&nbsp;Marie Scully","doi":"10.1016/j.jtha.2026.01.023","DOIUrl":"10.1016/j.jtha.2026.01.023","url":null,"abstract":"<div><div>Caplacizumab has been shown to reduce time to platelet normalization, reduce thrombotic thrombocytopenic purpura (TTP) exacerbations, and prevent refractory acute disease. We report the first case of caplacizumab “resistance” in a patient with immune TTP with a failure of suppression of <em>in vivo</em> von Willebrand factor (VWF) activity by the drug and persistence of VWF-mediated platelet capture in a flow-based <em>in vitro</em> assay. Genetic analysis revealed a missense variant, P1266L, in exon 28 of the <em>VWF</em> gene that affects the A1-domain binding site of glycoprotein Ib, but it is associated with normal platelet counts and the missense variant V1279I. Failure of caplacizumab therapy resulting in TTP exacerbation or relapse has to date been related to premature stopping of therapy associated with severe ADAMTS-13 (<em><strong>a</strong> <strong>d</strong>isintegrin <strong>a</strong>nd <strong>m</strong>etalloproteinase with a <strong>t</strong>hrombo<strong>s</strong>pondin type 1 motif, member <strong>13</strong></em>) deficiency. This case presents a previously unreported phenomenon involving a VWF variant that affects the A1 domain at the caplacizumab-binding site, impairing its effect.</div></div>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":"24 5","pages":"Pages 1881-1885"},"PeriodicalIF":5.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
National Institutes of Health funding for venous thromboembolism research 美国国立卫生研究院静脉血栓栓塞研究基金。
IF 5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2026-05-01 Epub Date: 2026-02-13 DOI: 10.1016/j.jtha.2026.01.020
Ryan A. Coute , Jake Toy , Kameshwari Soundararajan , Benjamin von Schweinitz , Patrick J. Siler , Ryan C. Godwin , Ryan L. Melvin
{"title":"National Institutes of Health funding for venous thromboembolism research","authors":"Ryan A. Coute ,&nbsp;Jake Toy ,&nbsp;Kameshwari Soundararajan ,&nbsp;Benjamin von Schweinitz ,&nbsp;Patrick J. Siler ,&nbsp;Ryan C. Godwin ,&nbsp;Ryan L. Melvin","doi":"10.1016/j.jtha.2026.01.020","DOIUrl":"10.1016/j.jtha.2026.01.020","url":null,"abstract":"<div><h3>Background</h3><div>Venous thromboembolism (VTE) is associated with approximately 100 000 deaths annually in the United States (U.S.). Progress in the prevention, diagnosis, treatment, and recovery from VTE depends on research funding. The National Institutes of Health (NIH), the world’s largest funder of biomedical research, does not currently report VTE-specific funding in its annual Categorical Spending Report.</div></div><div><h3>Objectives</h3><div>This study aimed to provide a descriptive analysis of NIH funding for VTE research over the past decade.</div></div><div><h3>Methods</h3><div>We conducted a search of the NIH Research Portfolio Online Reporting Tools Expenditures and Results database from 2015 to 2024 using a string of VTE-related search terms. Grants were categorized as VTE research (yes/no) using a large language model prompted with predefined classification criteria. We tabulated annual NIH funding amounts, the number of VTE-related grants, and the number of unique principal investigators. For 2023, VTE research investment was compared with that for heart disease and stroke, the leading causes of vascular mortality in the U.S.</div></div><div><h3>Results</h3><div>The search yielded 2130 grants with complete data, of which 1114 were classified as VTE research. When excluding renewal awards, 490 unique VTE grants were identified. Total inflation-adjusted NIH funding for VTE research was $42 million in 2015, peaked at $73 million in 2021, and totaled $67.1 million in 2024. In 2023, NIH funding per annual deaths was $2765 for heart disease, $2724 for stroke, and $639 for VTE.</div></div><div><h3>Conclusion</h3><div>NIH investment in VTE research has increased over the past decade, but remains disproportionately low relative to other major causes of vascular mortality in the U.S.</div></div>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":"24 5","pages":"Pages 1775-1781"},"PeriodicalIF":5.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
“A phase 1, open-label study to assess the pharmacokinetics, safety, and tolerability of a single intravenous injection of efanesoctocog alfa in adults with type 2N or type 3 von Willebrand disease”: comment 一项评估成人2N型或3型血管性血友病单次静脉注射efanesoctocog alfa的药代动力学、安全性和耐受性的1期开放标签研究:评论。
IF 5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2026-05-01 Epub Date: 2026-05-04 DOI: 10.1016/j.jtha.2025.12.029
Michelle Hyde , Cynthia Sabo , Charity Stadler , Madhvi Rajpurkar
{"title":"“A phase 1, open-label study to assess the pharmacokinetics, safety, and tolerability of a single intravenous injection of efanesoctocog alfa in adults with type 2N or type 3 von Willebrand disease”: comment","authors":"Michelle Hyde ,&nbsp;Cynthia Sabo ,&nbsp;Charity Stadler ,&nbsp;Madhvi Rajpurkar","doi":"10.1016/j.jtha.2025.12.029","DOIUrl":"10.1016/j.jtha.2025.12.029","url":null,"abstract":"","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":"24 5","pages":"Pages 1938-1940"},"PeriodicalIF":5.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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