This is an elegant paper which studied the hemostatic efficacy of different doses of rFVIIa and three of its analogs on controlling bleeding in mice with antibody induced hemophilia. There was significant decrease in blood loss, bleeding time, PT and APTT in the treated animals. rFVIIa analogs were 3-4 times more potent than rFVIIa, and […]
This is a very good review on the use and mechanism of action of rFVIIa in acquired hemophilia. It reviews the physiological coagulation pathway and the central role of factor VII and tissue factor, and the changes which occur in hemophiliac patients. It also reviews the pathogenesis of acquired hemophilia and the results of using […]
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 […]
Effective hemostasis with rFVIIa treatment in two patients with severe thrombocytopenia and life-threatening hemorrhage.
This article reports 2 patients with severe thrombocytopenia and severe hemorrhage which did not respond to standard therapy and platelet transfusion, but responded quickly to administration of a single dose of rFVIIa. The first patient had Waldenstoms macroglobulinemia and immune thrombocytopenia, and the second one had acute lymphoblastic leukemia. No adverse effects for rFVIIa were […]
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 […]
Successful use of recombinant activated factor VII for trauma-associated hemorrhage in a patient without preexisting coagulopathy.
This is a detailed first case report in the United States on using recombinant activated factor VIIa in treating massive uncontrollable bleeding following stab wound trauma to the liver in a patient with no pre-existing coagulopathy. Bleeding was not controlled in spite of two laparotomies, the transfusion of a large number of blood components and […]
Successful use of recombinant factor VIIa for hemostasis during total knee replacement in a severe hemophiliac with high-titer factor VIII inhibitor.
This is another case report of a successful use of rFVIIa in covering knee replacement surgery in a patient with severe hemophilia A and high-titer inhibitor. rFVIIa was given at a dose of 85 u/kg at 2-hourly interval initially, increasing the interval between infusions every 48 hours. Effective hemostasis was achieved. The authors recommend administering […]
Rationale for the use of high dose rFVIIa in a high-titre inhibitor patient with haemophilia B during major orthopaedic procedures.
This is a case report of a child with severe hemophilia B and high titer factor IX inhibitor who was not achieving good hemostasis on conventional doses of rFVIIa. Pharmacokinetic studies showed that he required higher doses of rFVIIa (240-320 μg/L) to maintain adequate levels of rFVIIa and achieve satisfactory hemostasis, due to higher clearance […]