This is a clearly written article detailing the mechanism of action of rFVIIa and its interaction with tissue factor and platelets leading to its hemostatic effect in hemophilia patients with inhibitors and those with platelet disorders. – Maadh Aldouri
This is an interesting report on a small series of children with inherited platelet dysfunction treated with rFVIIa for acute bleeding or preoperatively. Response seemed to correlate with type of underlying condition, severity of bleeding and delay in presentation. In this series rFVIIa had variable efficacy in securing hemostasis. There was no difference in requirement […]
This is an introduction for a supplement to the Canadian Journal of Anesthesia reporting proceedings of a satellite symposium presented at the 2002 Canadian Anesthesiologists’ Society Annual Meeting. It highlights the role of rFVIIa in managing bleeding in hemophilia patients with inhibitors, and the increasing number of case reports and studies in its role in […]
Sequential treatment with bolus and continuous infusion of recombinant factor VIIa for hip arthroplasty in a patient with haemophilia A and inhibitor.
This is a case report on a hemophilia VIII patient with high titer inhibitor who underwent total hip replacement and treatment with rFVIIa. rFVIIa was given as bolus treatment for 5 days, followed by continuous infusion with reduced doses for 12 more days. The patient made excellent recovery. The authors claim that using rFVIIa in […]
Efficacy of recombinant factor VIIa administered by continuous infusion to haemophilia patients with inhibitors.
This is an interesting study looking at the efficacy of administering rFVIIa in controlling bleeding in 43 episodes in 14 hemophilia patients with inhibitors. RFVIIa infusion was not effective in controlling oral bleeding, but effective in controlling bleeding in other sites. The authors postulate that rFVIIa infusion was not effective in activating thrombin activatable fibrinolysis […]
This study illustrates one of the unusual situations in Medicine where evidence of drug efficacy in human preceded animal studies. After the publication of several case reports on the effectiveness of rFVIIa in controlling traumatic bleeding, this study proves its efficacy in reducing bleeding after grade V liver injury in hypothermic dilutionally coagulopathic pigs, as […]
This is an interesting review on the use of continuous infusion of coagulation factor products over the last 11 years. It concludes that effects were favorable in comparison to intermittent bolus infusions. It suggests that continuous infusion has the advantage of maintaining a therapeutic level of the factor, and is associated with decrease in factor […]
Recombinant factor VIIa in the management of surgery and acute bleeding episodes in children with haemophilia and high responding inhibitors.
This study reports the effective use of rFVIIa in covering 20 surgical procedures in 12 patients with hemophilia VIII with high inhibitors, in addition to treating 6 episodes of severe bleeding in 3 patients successfully. All but one of the surgical procedures were insertion or removal of a central venous access device. This paper again […]
This is an interesting case report on the use of rFVIIa in covering surgical resection of a large right gluteal pseudo-tumor in a 32-year-old patient with severe hemophilia A and high-titer inhibitor. Factor VIIa was administered for 72 hours and monitored with measurement of PT and factor VII coagulation activity, and the latter was found […]
This a thorough and comprehensive review on the mechanism of action and various indications and uses of rFVIIa, highlighting the pivotal role of factor VII in hemostasis, as well as the efficacy and safety of rFVIIa. – M. Aldouri.
This article starts with a general overview on mechanism of action, uses and safety of rFVIIa as well as the hemostatic disorders which are associated with liver disease. It states the correlation between the degree of liver damage and level and gene expression of FVII. The authors reviewed the use of rFVIIa in liver disease […]
A single high dose of recombinant factor VIIa combining adjuvant therapy for controlling bleeding episodes in haemophiliacs with inhibitors.
A single dose of rFVIIa (150-180 μg/kg) was used to treat five muscle/joint bleeds and to cover 4 minor surgical procedures in 2 patients with hemophilia A and one with hemophilia B with inhibitors. Patients also received prednisolone, in addition to using fibrin glue, dental splint and tranexamic acid with surgical procedures. Treatment was either […]
This is another excellent review of the mechanism of action, indications, and various doses of rFVIIa (Novoseven) in hereditary bleeding disorders. Its main use has been in patients with factor VIII or IX deficiency with inhibitors, where rFVIIa can by-pass factors VIII or IX, interacts with tissue factor and generates thrombin in addition to activating […]
This is a report on off-label extended use of rFVIIa in managing pulmonary, vesical and GI haemorrhage in 3 patients post-BMT, who failed to respond to blood component transfusion and haemostatic medications. rFVIIa resulted in partial control of haemorrhage in 2 patients, and no effect in the third. No toxicity or adverse events were noted. […]