Table 1.

Main Modalities of Antithrombotic Treatments in Patients With Hemophilia According to the EHA, ISTH, EAHAD, ESO Guidance

Basal Factor VIII or IX Levels	Duration of Antithrombotic Treatment	Single Antiplatelet Therapy (Aspirin–Clopidogrel)	Dual Antiplatelet Therapy	Anticoagulation VKA DOAC (Full Dose)	Triple Therapy Dual Antiplatelet Therapy + VKA or DOAC
<20%a	Short and long term	Prophylaxis with FVIII or FIX Trough level: 1%–5% Or emicizumab	Prophylaxis with FVIII or FIX Trough level >20%	No anticoagulation Natural anticoagulation Avoid peak of FVIII/FIX >25% during prophylaxis	Prophylaxis with FVIII or FIX Trough level >80%
> 20%	Short and long term	Start	Start	Prefer DOAC	Prophylaxis with FVIII or FIX Trough level >80%

^aLowest factor level measured in case of discrepancy between 1-stage or chromogenic assays.

DOC = direct oral anticoagulant; EAHAD, European Association for Haemophilia and Allied Disorders; EHA, European Hematology Association; ESO, European Stroke Organisation; ISTH, International Society on Thrombosis and Haemostasis; VKA = Vitamin K antagonist.