The continuous infusion of recombinant activated factor VIIa (rFVIIa) in patients with factor VIII inhibitors activates the coagulation and fibrinolytic systems without clinical complications.
The standard modality of administration of rFVIIa to patients with FVIII and FIX inhibitors is the intermittent infusion every 2 to 6 hours. No untoward local or systemic effects have been reported; laboratory data of activation of coagulation were reported in the presence of coexistent problems (sepsis, septic shock) or with high doses. We treated four patients with FVIII inhibitor with rFVIIa administered by continuous infusion by a central vein catheter, monitoring the signs of systemic activation of the hemostatic system. The F(1+2) prothrombin fragments and the D-dimer increased after the bolus, and remained above the baseline values throughout the treatment period. These variations observed during the infusion period were not accompanied by clinical events.
Baudo
F
F
Hemostasis and Thrombosis Unit, Niguarda Hospital, Milan, Italy. md9821@mclink.it
Redaelli
R
R
Caimi
T M
TM
Mostarda
G
G
Somaini
G
G
de Cataldo
F
F
D000328:Adult; D000368:Aged; D001777:Blood Coagulation / Q000187:drug effects* / Q000502:physiology; D002405:Catheterization, Central Venous; D005167:Factor VII / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology; D005169:Factor VIII / Q000037:antagonists & inhibitors / Q000276:immunology*; D015942:Factor VIIa; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D005342:Fibrinolysis / Q000187:drug effects* / Q000502:physiology; D006406:Hematoma / Q000139:chemically induced / Q000188:drug therapy; D006467:Hemophilia A / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D007518:Isoantibodies / Q000097:blood; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood / Q000378:metabolism; D010976:Platelet Count; D011516:Prothrombin / Q000378:metabolism; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology
D005338:Fibrin Fibrinogen Degradation Products; D007518:Isoantibodies; D010446:Peptide Fragments; D011994:Recombinant Proteins; C036309:fibrin fragment D; C045879:prothrombin fragment 1.2; D005167:Factor VII; D011516:Prothrombin; D005169:Factor VIII; D005340:Fibrinogen; C103587:recombinant FVIIa; D015942:Factor VIIa