The year 2020 was rich in developments and innovations in the field of thrombotic and hemorrhagic disorders. With respect to both its complex physiopathology and its multifaceted antithrombotic treatment, the coagulopathy linked to COVID-19 has aroused major interest that is far from being exhausted. Direct oral anticoagulants (DOACs) continue to be developed and validated, particularly in cancer-related venous thromboembolic diseases and for managing heparin-induced thrombocytopenia. The data on the DOAC use in early pregnancy appear reassuring. While these agents should indeed be avoided during pregnancy, the available data do not justify voluntary pregnancy termination as based on DOAC exposure alone. Mortality in catastrophic anti-phospholipid syndrome (CAPS) is likely to be significantly reduced when two antibodies, consisting of eculizumab and rituximab, are incorporated into the treatment regimen. As regards congenital hemophilia, the publication of new international recommendations by the World Federation of Hemophilia has attracted a great deal of attention, as have new therapeutic advances, including the validation of an ultra-long half-life FVIII concentrate (BIV001). Emicizumab is a bispecific antibody mimicking the action of FVIII that appears to be very promising. In addition to this drug’s use in managing congenital hemophilia A, it is also indicated in managing acquired hemophilia A.
Key Words
COVID-19, coagulopathy, cancer, direct oral anticoagulants, hemophilia, acquired hemophilia, acquired hemophilia, catastrophic antiphospholipid syndrome