This is an extremely important, long-awaited study on the effect of rFVIIa in management of intracerebral haemorrhage. It is a double-blind, placebo-controlled study which enrolled 399 patients into control placebo and 3 treatment arms using 40 g, 80 g, and 160 g of rFVIIa per kilogram of body weight. There was significant reduction in growth of hematoma, severe disability and death in the rFVIIa treatment arms, associated with a nonsignificant increase in thromboembolic events in patients who received rFVIIa, and dose response effect was evident. Early use of rFVIIa therapy therefore improved outcome of patients with intracerebral haemorrhage, but should be used with caution in patients with known thromboembolic tendency.

– Maadh Aldouri