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Article History

Received: 4 July 2025

Accepted: 28 October 2025

First Online: 19 November 2025

Declarations

:

: All participants were given a clear and comprehensive explanation of the study on the basis of the Declaration of Helsinki. Subsequently, participants signed informed consent forms. Ethical approval for the studies was obtained from both the Nara Medical University (ID: 2097) and Chugai Ethics Committees (ID: E19086).

: No identifiable subject information is provided in the manuscript, figures, or tables.

: YM, AS, MS, NM, RK, TS, KT, and KN are members of the Medicinal Biology of Thrombosis and Haemostasis established by Nara Medical University and Chugai Pharmaceutical Co., Ltd. NM, RK, and TS are employees of Chugai Pharmaceutical Co., Ltd. NM and RK have stock ownership of Chugai Pharmaceutical Co., Ltd. MS is a representative of the Medicinal Biology of Thrombosis and Haemostasis collaborative research laboratory; research support from Chugai Pharmaceutical Co., Ltd.; Takeda Pharmaceutical Co., Ltd.; and CSL Behring; received honoraria or consultation fees from Chugai Pharmaceutical Co., Ltd.; is a speaker for Chugai Pharmaceutical Co., Ltd.; and CSL Behring, Sanofi, Bayer, Novo Nordisk Pharma, Takeda Pharmaceutical Co., Ltd., Pfizer, and Fujimoto Seiyaku Corp.; and has patents for inventions relating to products of Chugai Pharmaceutical Co., Ltd.CH has no conflict of interest to decare. KO has received personal fees from Chugai Pharmaceutical Co., Ltd., and CSL Behring. SF taught a course endowed by CSL Behring and received personal fees from Chugai Pharmaceutical Co., Ltd., CSL Behring, Takeda Pharmaceutical Co., and Sanofi S.A.NS taught a course endowed by CSL Behring.KT received grants or research support from the Japan Blood Products Organization, The Mother and Child Health Foundation and Novo Nordisk Pharma. YI received specified clinical trial funding from MediaMart Co., Ltd.; research funding from Chugai Pharmaceutical Co., Ltd., Johnson & Johnson K.K., KM Biologics, Olympus Terumo Biomaterials Corp., and Zimmer Biomet; and honoraria from Asahi Kasei Pharma Corporation, Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., CSL Behring, Healious K.K., Hisamitsu Pharmaceutical Co., Johnson & Johnson K.K., Ono Pharmaceutical Co., Ltd., Novo Nordisk Pharma Ltd., Sanofi K.K., and Takeda Pharmaceutical Co., Ltd.; and is a medical advisor for Chugai Pharmaceutical Co., Ltd. and KM Biologics.AK received personal fees from Hisamitsu Pharmaceutical Co. and Tsumura & Co. KN received grants, personal fees, and nonfinancial support from Chugai Pharmaceutical Co., Ltd.; personal fees from Hoffmann-La Roche Ltd.; grants and personal fees from Sysmex Co., SEKISUI MEDICAL., Takeda Pharmaceutical Co., Sanofi S.A., Co., Ltd., CSL Behring Co., KM Biologics Co., Ltd., Novo Nordisk A/S, Bayer AG, and Fujimoto Seiyaku; is an inventor of patents relating to emicizumab; and is a member of the Medicinal Biology of Thrombosis and Haemostasis established by Nara Medical University and Chugai Pharmaceutical Co., Ltd.