This is an overview on the mechanism of action of rFVIIa and its role in hemostasis. rFVIIa directly activates FX, increases thrombin activation on activated platelets, and leads to generation of strong fibrin clot which is more resistant to fibrinolysis. rFVIIa exerts its action by interacting with tissue factor, but this group showed that high […]
A novel hemostatic agent: the potential role of recombinant activated factor VII (RFVIIa) in anesthetic practice.
This is an excellent literature review on the adjuvant use of rFVIIa in treating severe bleeding associated with surgical procedures in non-hemophiliac patients. It gives an overview of the mechanism of action of rFVIIa and its efficacy in patients with hemophilia, platelet dysfunction and liver disease. It also reviews its efficacy in managing bleeding in […]
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 […]
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 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. […]
New products for managing inhibitors to coagulation factors: a focus on recombinant factor VIIa concentrate.
A very good review of inhibitors to coagulation factors, in congenital or acquired hemophilia, that covers the incidence, pathogenesis, treatment strategies (including different alternatives to human factors), and induction of immune tolerance. The article contains an algorithm approach for the management of such patients, with emphasis on the use of rFVIIa in managing hemophiliac patients […]