HFA met with Prof Cedric Hermans during the Australian Bleeding Disorders Conference 2025. Prof Cedric is from Saint-Luc University Hospital, Belgium, and spoke with us on a variety of topics, including:
- The changing landscape of treatment options for haemophilia and other bleeding disorders
- Women and girls with bleeding disorders
- The importance of diagnosis
Watch the video below:
Video transcript:
Pauline: Hi, I’m Pauline from Haemophilia Foundation Australia, and today I’m talking to Professor Cedric Hermans from Saint-Luc University Hospital in Brussels, Belgium.
Cedric, what’s brought you to Australia?
Cedric: Well, contributing to this great meeting that took place over the last two days. Sharing experience, meeting beautiful colleagues, nice people, great experience.
Pauline: Can you tell me a little bit about what you’ve been presenting here at the Australian Bleeding Disorders Conference?
Cedric: Well, first I try to give an overview of the quickly changing landscape of different treatment options for patients with haemophilia.
So it’s clearly fascinating you know, patients used to be treated with concentrate of factor eight to factor nine given intravenously. But this is quite challenging for many reasons. This treatment has to be given IV, they have a short half life rapidly eliminated from the blood, and on top of that, many of them do induce the generation of antibodies. So they are not well tolerated.
Today we have plenty of different treatment options.
We have long acting factor eight (VIII), factor nine (IX), even super acting factor eight.
We have this beautiful bispecific antibody that mimics factor eight. It can be given sub cut (subcutaneous).
We also have plenty of very original treatment options. We call them the rebalancing agents. This is a bit complex. So how do they work? They do not replace factor eight or factor nine, but they help to generate what we call thrombin. Thrombin is key. Thrombin helps to generate the clots, and these agents help to generate more thrombin. The good news is that they are given subcut again, and they can be given for haemophilia A, haemophilia B with and without inhibitors. So really promising.
And then we have gene therapy for haemophilia A and certainly for haemophilia B, which looks quite promising. And we had very good testimonies here from patients who underwent gene therapy even here in Australia.
So clearly things are changing. And the good news is that, patients can now be on prophylaxis. And what we expect is to have zero bleeds in all patients and a normal life, physically and mentally.
Pauline: Would you say that the treatments for other bleeding disorders are also progressing, other than haemophilia?
Cedric: Well, yes. Less quickly and, maybe less efficiently, but we see more and more treatment options, including for patients with von Willebrand, some rare clotting factor deficiency. Yes, but it’s clear that for the moment, patients with haemophilia, certainly do benefit from more rapid advances. But I’m quite optimistic for the other patients.
Pauline: I know that you’re also very well versed in how the treatment landscape is changing for women and girls with bleeding disorders.
Cedric: Yeah, well, first of all, what we need to do is to make sure that we identify these women. Clearly, there is a lack of diagnosis. Many have not been diagnosed, or poorly diagnosed. So I emphasise the importance of awareness and proactivity. So we need to do everything possible to make sure that these ladies who have bleeding problems are diagnosed. And for them, especially if they are carriers of haemophilia A and B, I think we have excellent treatment options today.
The problem is that many of these treatment options have not been extensively validated, but clearly we are now getting data showing that they work in women and girls with haemophilia. For other diseases it could be a little bit more complicated – for von Willebrand, for factor seven (VII) deficiency, factor eleven (XI) – but again, I think now we have other treatment options too that can certainly help all these women.
Pauline: So the 2026 theme for World Haemophilia Day is about the journey to diagnosis and the importance of that diagnosis. Can you tell me a bit about how we can go about improving diagnosis? Not necessarily just in Australia but around the world as well?
Cedric: I think it’s a great and important topic and a fabulous initiative. Why? Because there are so many patients, or so many persons, I would say, who present with bleeding symptoms. But there are fewer persons who have been diagnosed with a bleeding disease.
So there is a huge gap. Why? Because many person do present with bleeding symptoms in their daily life. Sometimes they underestimate the importance of this, or even the doctors underestimate the importance of this.
So I think it’s important to make sure that all these persons who have a bleeding tendency are well diagnosed and then end up, you know, in, in our hands, as haematologists or blood coagulation specialists, who can really, confirm that there is an abnormal bleeding tendency and that we can identify what’s responsible for this.
Let’s be honest, the blood coagulation process is very complicated, you have plenty of players…
Pauline: I saw your presentation earlier explaining the cascading diagram, and I was honestly, you get a little bit lost.
Cedric: Yeah, it’s not only the cascade, you know. Yes we have the clotting factors, but we have the blood vessels. We have the platelets inside. We have all these clotting factors who do a great work when they work together. And then, you know, we have all these, mechanisms in place that do preserve the clot.
So it’s very complex. Sometimes, identifying what’s wrong inside this process is complicated, but clearly emphasizing the importance of diagnosis. Let’s make sure that we do not underestimate or misdiagnose, bleeding symptoms.
I think this is a critical step if we want to improve the management of bleeding disease globally.
Pauline: Thank you for joining me today, Cedric.
Cedric: It was a great pleasure. Thank you.