INTRODUCTION: Emicizumab-kywh (ACE910) is a recombinant, humanized, asymmetric 
bispecific antibody that functions to bring activated FIX (FIXa) and zymogen FX 
into an appropriate steric conformation to medicate the activation of FX to FXa 
thereby mimicking the cofactor function of FVIIIa.
AIM: The objective of this manuscript was to review the development and 
potential role for emicizumab in the treatment of patients with haemophilia A 
with and without inhibitors.
METHODS: A Cochrane Library and PubMed (MEDLINE) search focusing on emicizumab 
in haemophilia was conducted.
RESULTS: In total, 37 citations were retrieved and serve as the database for the 
literature reviewed herein. Once-weekly subcutaneous injection of emicizumab at 
three dose levels has been shown to be effective as prophylaxis to prevent 
bleeding in a majority haemophilia A patients with inhibitors to FVIII. 
Likewise, prevention of bleeding was also observed in more than two thirds of 
patients without inhibitors to FVIII. One antidrug antibody to emicizumab has 
been reported in over 600 treated patients, two have developed thromboembolic 
events and three thrombotic microangiopathy. These thrombotic complications have 
occurred in conjunction with FVIII-bypassing agents, and none have been observed 
following recommendations from the manufacturer regarding concomitant use of 
bypassing agents. The median annual treated bleeding rates were decreased in 
patients with as well as those without an inhibitor to FVIII.
CONCLUSION: The principal advantage of emicizumab is subcutaneous administration 
and effectiveness irrespective of the presence of inhibitors. Emicizumab could 
conceivably represent a new epoch in the treatment of people with haemophilia A.