Abstract
The management of patients with congenital hemophilia who develop alloantibodies that
neutralize coagulation factor activity is the most important challenge for hemophilia
care providers because this complication renders replacement treatment with factor
concentrates partially or completely ineffective, exposing the patients to an increased
risk of morbidity and mortality. Development of inhibitors complicates the clinical
course of severe hemophilia in up to 30% of patients with hemophilia A and up to 5%
of those with hemophilia B. Although the ultimate goal of treatment of patients with
alloantibodies against factors VIII and IX is eradication of the inhibitor, the control
of bleeding through high doses of factor concentrates (low titer inhibitors) or bypassing
agents (high titer inhibitors) is the mainstay of management of these patients. In
this review, we summarize the main characteristics of the bypassing agents FEIBA and
NovoSeven, briefly discussing available literature data, and in particular, focusing
on comparative studies.
Keywords
FEIBA - NovoSeven - bypassing agents - inhibitors - alloantibodies - congenital hemophilia
- bleeding
