Name of the Procedure:

• Injection, Emicizumab-KXWH, 0.5 mg (HCPCS Q9995)
• Common name: Hemlibra Injection
• Technical/Medical term: Emicizumab-kxwh subcutaneous injection

Summary

Emicizumab-kxwh injection is a medical treatment where a small quantity of medication is injected subcutaneously (under the skin). It is primarily used to manage and prevent bleeding episodes in individuals with hemophilia A.

Purpose

• Medical Conditions/Problems: Hemophilia A, a genetic disorder that affects the blood's ability to clot
• Goals/Expected Outcomes: To reduce the frequency and severity of bleeding episodes, enhance patient quality of life, and prevent potential complications associated with hemophilia A.

Indications

• Specific Symptoms or Conditions: Individuals diagnosed with hemophilia A
• Patient Criteria: Patients with hemophilia A, including those with factor VIII inhibitors

Preparation

• Pre-procedure Instructions: No specific fasting or medication adjustments required.
• Diagnostic Tests or Assessments: Baseline coagulation studies and regular monitoring of factor VIII levels might be necessary.

Procedure Description

1. Step-by-Step Explanation:

   • Confirm patient details and medication dosage.
   • Clean the injection site with antiseptic.
   • Use a sterile needle and syringe to draw the prescribed dose of Emicizumab-kxwh.
   • Inject the medication subcutaneously into the preferred site (usually the abdomen, thigh, or upper arm).
   • Dispose of the needle and syringe in a sharps container.

2. Tools/Equipment:

   • Sterile needle and syringe
   • Antiseptic swabs
   • Sharps disposal container

3. Anesthesia or Sedation:

   • Not required as it is a simple subcutaneous injection.

Duration

• The injection procedure typically takes about 5-10 minutes.

Setting

• Usually performed in an outpatient clinic or home setting after proper instruction.

Personnel

• Administered by a trained healthcare professional, such as a nurse or doctor.
• Can also be self-administered by the patient or caregiver after proper training.

Risks and Complications

• Common Risks: Injection site reactions (redness, swelling, itching)
• Rare Risks: Hypersensitivity reactions, thrombotic microangiopathy, or anaphylaxis. Immediate medical attention is required if severe reactions occur.

Benefits

• Expected Benefits: Reduced frequency of bleeding episodes, improved management of hemophilia A, and overall enhancement in quality of life.
• Realization Timeline: Benefits may be noticed within weeks of regular administration.

Recovery

• Post-procedure Care: Monitor for any adverse reactions at the site of injection.
• Expected Recovery Time: Immediate return to normal activities post-injection with adherence to periodic follow-up for ongoing assessment.

Alternatives

• Other Treatment Options:
  • Traditional factor VIII replacement therapy
  • Bypassing agents for those with inhibitors
• Pros and Cons:
  • Emicizumab offers the advantage of less frequent dosing and subcutaneous administration compared to intravenous factor VIII infusions. However, it might not be suitable for all patients due to different response rates and potential side effects.

Patient Experience

• During the Procedure: Minor discomfort or pain at the injection site.
• After the Procedure: Mild soreness or redness at the injection site which usually resolves quickly. Pain management can include over-the-counter pain relievers if needed, with guidance from a healthcare professional.