Semin Thromb Hemost 2000; Volume 26(Number 4): 0407-0412
DOI: 10.1055/s-2000-8460
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel. +1(212)584-4662.

The Treatment of Bleeding in Hemophilic Patients with Inhibitors with Recombinant Factor VIIa

Claude Negrier, Charles R. M. Hay
  • Centre Régional de Traitement de l'Hémophilie, laboratoire d'Hémostase, Hopital Edouard Herriot, Lyon, France (CN) and University Department of Haematology, Manchester Royal Infirmary, Manchester, England (CRMH).
Further Information

Publication History

Publication Date:
31 December 2000 (online)

ABSTRACT

-Recombinant factor VIIa (rFVIIa) has proven efficacy in the treatment of patients with alloantibodies and autoantibodies to factors VIII and IX. More than 80% of over 2,000 reported bleeding episodes treated with rFVIIa have been controlled in a variety of clinical circumstances. Its theoretical lack of activation of the coagulation system prompted many clinicians to undertake elective surgical procedures using rFVIIa in addition to on-demand treatment of minor bleeding episodes. Hemostatic efficacy has been good for most of these surgical procedures, without serious adverse events. rFVIIa is considered a useful, safe, and effective treatment for bleeding in patients with anti-factor VIII (FVIII) and anti-factor IX (FIX) inhibitors. However, the optimal dose for various clinical situations has yet to be established and requires further investigation. Laboratory monitoring of treatment using plasma FVIIa measurements should be better standardized. Despite the relatively high cost of this new drug, rFVIIa represents a major therapeutic advance in the treatment of hemophilic patients with inhibitors.