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 […]
Comments were given by the authors on the paper by Martinowitz et al., mentioning that the study was not case controlled, the dose regimen was variable, how can thrombotic complications be excluded, where were the patients bleeding from. Dr. Martinowitz replied that published animal studies supported the data. There was agreement that larger randomized studies […]