ISTH 2024, BANGKOK, THAILAND

This blog is a reflection of interesting musings from my recent sojourn to Bangkok, Thailand for the International Society of Haemostasis and Thrombosis (ISTH) annual congress in June 2024. I am grateful to HaemSTAR for the opportunity to have been part of the meeting via the HaemSTAR ISTH Legacy Fund award. 

This was such a vibrant meeting with my interest particularly drawn to a number of interesting and thought-provoking abstracts and talks. With a shameless paediatric haematology bias, I sauntered into venues scanning for paediatric themed updates. I had walked straight in on arrival into a masterclass session on approach to children with thrombosis in the background of inherited protein C deficiency. The challenge of equity of access was evident with a diverse spectrum of attendees either having access to protein C concentrate, fresh frozen plasma or just simply sticking to long term anticoagulation. It was a reminder of the need to have adaptable guidelines and the fact that various regional or national health financing bodies are obviously unlikely to have read an international best practice guideline when allocating resources! 

It was particular reassuring to again see a couple of poster abstracts from across the globe corroborating real world safety and efficacy data on use of rivaroxaban for paediatric VTE as had been previously reported from similar such single and multicentre studies in the UK. This may in future open a discussion into a complete needle free approach to paediatric thrombosis in the future. 

Moving away from thrombosis the encouraging data on safety and efficacy from FRONTIER2 on use of the Factor VIIIa mimetic, Mim8 was of interest. It is positioned as the next generation optimised Factor VIIIa mimetic but it certainly has some lofty heights to aim for as those in the haemophilia community know, there is certainly no recent dearth of options for Haemophilia A. 

Taking a break from the conference site to join in a pharma-organised lovely dinner at the highly recommended Garden of Dinsor Palace in Bangkok was refreshing (thanks to Jessica Sandham, Haematologist at Liverpool!). It was also inspiring as it was a pleasure to dine with experts in the haemostasis field as well as one of haemophilia’s finest researchers, Dr Steve Pipe from Michigan, USA who needs no introduction for his role in the HAVEN trials and Gene therapy trials.  

Back to the conference there were a number of thought-provoking abstracts on display. For example, an abstract on effective implementation of pharmacy led anticoagulation clinics in the DOAC era in a Singapore centre showed good patient experience and was safely delivered. A study on bone health screening in paediatric patients on chronic warfarin therapy caught my attention as this is a poorly discussed issue. In this study from the Nationwide Children’s Hospital and The Ohio State University, both in the USA, the key finding was that a striking 75% of these children were at risk for low bone mineral density potential, making them a fracture risk. This exemplifies the need for more attention to be paid to children on chronic warfarin therapy using a multidisciplinary care approach. 

Overall this was an excellent conference which was not only of huge personal clinical benefit for me but also great for collaboration with colleagues across the globe. I am grateful to HaemSTAR and the ISTH Legacy fund for the opportunity to attend ISTH 2024 in Thailand.