Three cases of hemophilia A with inhibitors to factor VIII underwent total knee arthroplasty (TKA) using rFVIIa in the first patient, rFVIIa and high dose rFVIII in the second and porcine FVIII in the third patient with effective hemostasis. In case 1, a second TKA was managed with a high dose of rFVIIa (180 mg/kg) […]
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 is an excellent review on a large series reporting the use of rFVIIa in orthopedic surgeries in patients with hemophilia A and B with inhibitors, in addition to a review of the literature. Major orthopedic procedures were carried out, as well as multiple proce-dures on the same patients were possible with very good efficacy […]
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 […]
This is a case report of successfully treating hemorrhage with rFVIIa in four patients with factor VIII and one with factor V inhibitor. One patient was initially treated with APCC (Autoplex) and blood products unsuccessfully. The authors confirm the efficacy and safety of rFVIIa and suggest carrying out cost effectiveness analysis. Further information is required […]
The mechanism of inducing hemostasis by factor VII (FVII) in hemophilia patients with inhibitors is not fully understood. Tissue factor (TF) and FVII are required to form a small concentration of thrombin (initiation phase) followed by increased activation of clotting factors and formation of a solid clot (propagation phase). This paper studies a model for […]
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 […]