Summary
Fibrinogen concentrate use as a haemostatic agent has been increasingly explored.
This study evaluates spontaneous reports of potential adverse drug reactions (ADRs)
that occurred during postmarketing pharmacovigilance of Haemocomplettan P/RiaSTAP,
and reviews published safety data. This descriptive study analysed postmarketing safety
reports recorded in the CSL Behring pharmacovigilance database from January 1986 to
December 2013. A literature review of clinical studies published during the same period
was performed. Commercial data indicated that 2,611,294 g of fibrinogen concentrate
were distributed over the pharmacovigilance period, main-contribonding to 652,824
standard doses of 4 g each, across a range of clinical settings and indications. A
total of 383 ADRs in 106 cases were reported (approximately 1 per 24,600 g or 6,200
standard doses). Events of special interest included possible hypersensitivity reactions
in 20 cases (1 per 130,600 g or 32,600 doses), possible thromboembolic events in 28
cases (1 per 93,300 g or 23,300 doses), and suspected virus transmission in 21 cases
(1 per 124,300 g or 31,000 doses). One virus transmission case could not be analysed
due to insufficient data; for all other cases, a causal relationship was assessed
as unlikely due to negative polymerase chain reaction tests and/or alternative explanations.
The published literature revealed a similar safety profile. In conclusion, underreporting
of ADRs is a known limitation of pharmacovigilance. However, the present assessment
indicates that fibrinogen concentrate is administered across a range of indications,
with few ADRs and a low thromboembolic event rate. Overall, fibrinogen concentrate
showed a promising safety profile.
Institution to which work should be attributed: CSL Behring, Marburg, Germany.
Keywords
Fibrinogen - pharmacovigilance - safety