Transforming hemophilia care: emerging therapeutic innovations and challenges.

Introduction: Hemophilia A and B are lifelong bleeding disorders traditionally managed with factor replacement therapy. While effective, this approach is limited by frequent infusions, inhibitor development, and high treatment costs, underscoring the need for innovative therapies that improve patient outcomes and quality of life.

Areas covered: This review explores recent advances in hemophilia management, focusing on extended half-life factor concentrates, non-factor therapies such as bispecific antibodies and rebalancing agents, and the emergence of gene therapy as a potential functional cure. English-language studies on hemophilia therapies were searched in PubMed, Embase, Web of Science, and ClinicalTrials.gov (Jan 2014 to Apr 2025). A comprehensive literature review was conducted, covering pivotal clinical trials, real-world data, and translational research addressing both efficacy and safety considerations.

Expert opinion: Innovative therapies are transforming hemophilia care, offering simplified administration, superior bleed prevention, and new hope for patients with inhibitors. Gene therapies mark a milestone, but present challenges related to durability, immune response, and cost. Personalized treatment strategies, integrating patient-specific factors and shared decision-making, are essential to optimizing outcomes. Continued research, long-term surveillance, and efforts to improve global access will define the next era of hemophilia management, moving closer to a future where patients can lead lives free from the burden of bleeding.