Management of hemophilia patients with inhibitors.
rFVIIa seems to offer an alternative in the treatment of hemophiliacs as well as nonhemophiliacs with antibodies against FVIII/FIX. The treatment can be given regardless of the inhibitor titer in those patients and is also hemostatically active in hemophilia B patients. It is easy to administer but seems to need a repeated dosing at 2- to 3-hour intervals, at least initially in severe bleedings. A dose of 70 to 100 micrograms/kg body weight seems to induce hemostasis. Depending on the severity of the bleeding, the dose intervals may then be prolonged to 3 hours for 1 to 2 days or until clinical improvement is observed. Thereafter, the dosage interval can be increased to 4 hours if continued therapy is indicated.
Hedner
U
U
Research Department, Novo Nordisk, Gentofte, Denmark.
Glazer
S
S
D005164:Factor IX / Q000037:antagonists & inhibitors / Q000276:immunology*; D005169:Factor VIII / Q000037:antagonists & inhibitors / Q000276:immunology*; D015942:Factor VIIa / Q000627:therapeutic use; D006467:Hemophilia A / Q000150:complications / Q000276:immunology / Q000628:therapy*; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007165:Immunosuppression Therapy; D007518:Isoantibodies / Q000276:immunology*; D011516:Prothrombin / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use
D007518:Isoantibodies; D011994:Recombinant Proteins; D011516:Prothrombin; D005169:Factor VIII; D005164:Factor IX; D015942:Factor VIIa