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ISTH 2025 Congress Chronicle: Reflecting on a successful ISTH 2025 Congress

July 2025

By: Guy Young, M.D.

ISTH 2025 Congress Chair

Did you think I was going away already? I promise after this Congress Chronicle I will go quietly away! After hearing from so many of you about how much you enjoyed the ISTH 2025 Congress, and after obviously experiencing it myself as an audience member in many sessions, I thought it would be nice to provide some of my post-Congress perspectives.

First off, I and the rest of the Annual Congress Planning Committee (ACPC) are so appreciative that so many of you came up to us during the Congress to tell us how much you were enjoying the meeting and how you thought the program was really great and well-conceived. I had told those who came up to me how satisfying it was to hear that, as we really did put a lot of time and effort into putting on the best Congress we could. Many of you even told me, the ACPC and the ISTH staff that you thought it was the best ISTH Congress ever! Thank you to all those who said that and to all of you who thought that but did not have the opportunity to tell us that in person.

I agree that the meeting, and especially the science, was incredible. There were so many great studies and presentations. Remember that you can watch recorded sessions from the Congress on the ISTH Academy. Additionally, all Congress abstracts are available in Research and Practice in Thrombosis and Haemostasis (RPTH).

Here are some of the studies that have really stuck with me (with the caveat that I mostly attended clinical sessions). I heard from the ACPC Basic Science Chair Alisa Wolberg that there was incredible basic science presented as well. So, let me begin and I will state those thoughts as questions:

Might we be nearing the end of needing to do plasma exchange in thrombotic thrombocytopenic purpura (TTP)? See the late breakthrough abstract on the Mayari study led by Paul Coppo. I actually just admitted a 14-year-old girl with TTP, and while we did start plasma exchange, maybe the next one can be treated without having to place an apheresis catheter that she and her parents wish she did not need.
Should we rethink our use of direct oral anticoagulants (DOACs)? The COBRRA study led by Lana Castellucci presented in the late breakthrough session demonstrated less bleeding with apixaban versus rivaroxaban. Maybe it is just a dosing issue with the 3-week high dose period with rivaroxaban—which, by the way we do not do in children and have exceptionally low bleeding with rivaroxaban. Hmm?
Are we on the cusp of a subcutaneous bleed prevention treatment for von Willebrand disease with HMB-002? See the results in the late breakthrough session on the VELORA study.
Regarding hemophilia, we always dreamed about having an oral therapy to prevent bleeding, but for decades it was just that—a dream. Check out the abstract on Inno8 presented by Jacob Lund to learn more.
We now have Adeno-associated virus (AAV)-based gene therapy approved in some countries for hemophilia A and B, but we have been confident (even in the absence of data) that this approach would not work in young children given the non-integrating fashion of AAV-based gene therapy and the anticipated liver growth in children. But Paul Batty and separately Tim Nichols demonstrated that AAV-based gene therapy in young dogs, contrary to prior thought, resulted in sustained factor levels (read more here). This is why doing the hard science and ignoring unproven theories matters.

There was plenty more great science, but alas there is only room to write so much. I guess I would say that the science at the ISTH 2025 Congress was like the weather was in Washington, D.C.: HOT! Despite the heat, I hope many of you enjoyed the great attractions and restaurants that Washington, D.C. has to offer.

Lastly, I thought the Plenaries were all fantastic! I mean the truth is they usually are always great at an ISTH Congress, and I praise our four Plenary speakers for giving not just informative but also inspiring talks. I also was pleased we could give our ISTH awardees more time compared to previous meetings by extending the awards outside of the Opening Session before each Plenary Session.

Speaking of the Opening Session, I was pleased to have some time to give thanks to my mentors, the ACPC and others during my speech at the Opening Ceremony. Of course, I had to do it in the “Guy Young style” and bring in some fun and humor—and even new sneakers for Tom Reiser. But in true Guy Young style, I realize that my humor at times may have crossed some lines, and I did hear that some of my humor particularly regarding nationalities and cultures I mentioned in the speech offended some people. I truly apologize for that. I certainly did not intend to do so, but that does not change the fact that it was offensive to some people.

I, and the ISTH, sincerely respect and value the diversity of cultures and perspectives within the Society and regret any offense my words may have caused. I strongly support the ISTH’s commitment to inclusivity and appreciate being part of a global community that celebrates and welcomes all voices. If anyone wishes to reach out to me personally to discuss this, I am more than open to listening and will be gracious in my response.

So, this really is it. No more Congress Chronicles from me. Thank you as always for reading this. I will finally take some vacation in Montana with my wife. Later this summer I am also looking forward to a father-son trip with my recently graduated oldest son to Australia.

I look forward to seeing you all at the ISTH 2026 Congress in Paris next year. Stay tuned to the ISTH channels for the latest updates.