Reduced coagulation activation following infusion of a highly purified factor IX concentrate compared to a prothrombin complex concentrate.
We have looked for evidence of coagulation activation in six subjects with haemophilia B by performing a single-blind active control cross-over study comparing a recently developed factor IX concentrate with a conventional prothrombin complex concentrate (PCC). Samples were obtained before infusion and at 0.25, 0.5, 1, 2, 4, 6, 12, 24, 36 and 48 h for assay of factor IX, prothrombin time, fibrinopeptide A (FPA), prothrombin fragment F1 + 2, D-dimer, thrombin-antithrombin complexes (TAT) and antithrombin III (ATIII). Following administration of the PCC there was evidence of coagulation activation in five of the six recipients for up to 6 h after the infusion. The factor IX concentrate induced a moderate degree of coagulation activation in one subject. There was no significant difference between the two products in respect of either recovery or half-life. This study provides further evidence that the new high purity preparations of factor IX concentrates produce significantly less coagulation activation than currently available PCCs. It remains to be established whether this will result in a corresponding reduction in thromboembolic complications in clinical use.
Department of Haematology, Royal Hallamshire Hospital, Sheffield.
K K
KK
Hampton
F E
FE
Preston
G D
GD
Lowe
I D
ID
Walker
B
B
Sampson
D000293:Adolescent; D000328:Adult; D000990:Antithrombin III / Q000032:analysis; D001777:Blood Coagulation / Q000187:drug effects*; D001779:Blood Coagulation Factors / Q000494:pharmacology*; D004340:Drug Contamination; D005164:Factor IX / Q000494:pharmacology*; D005344:Fibrinopeptide A / Q000032:analysis; D002836:Hemophilia B / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis; D010447:Peptide Hydrolases / Q000032:analysis; D011516:Prothrombin / Q000032:analysis; D016037:Single-Blind Method; D013997:Time Factors
D001779:Blood Coagulation Factors; D010446:Peptide Fragments; C046193:antithrombin III-protease complex; C045879:prothrombin fragment 1.2; D005344:Fibrinopeptide A; C025667:prothrombin complex concentrates; D000990:Antithrombin III; D011516:Prothrombin; D005164:Factor IX; D010447:Peptide Hydrolases