The use of recombinant factor VIIa in the treatment of bleeding disorders.
Recombinant factor VIIa was initially developed for the treatment of hemorrhagic episodes in hemophilic patients with inhibitors to factors VIII and IX. After its introduction, it has also been used "off-label" to enhance hemostasis in nonhemophilic patients who experience bleeding episodes not responsive to conventional therapy. Evidence so far indicates that the use of factor VIIa in hemophilic patients with inhibitors is both safe and effective. Anecdotal reports also suggest that the product is safe and effective in controlling bleeding in nonhemophilic patients. However, its use in these conditions has not been approved by the FDA, and conclusive evidence of its effectiveness from controlled clinical trials is not yet available. Several questions pertaining to the use of factor VIIa require further investigation, including the mechanism of action; the optimal dose; definitive indications; ultimate safety; and laboratory tests for monitoring therapy.
Roberts
Harold R
HR
Division of Hematology/Oncology, Department of Medicine and the Carolina Cardiovascular Biology Center, 932 Mary Ellen Jones Bldg, Chapel Hill, NC 27599-7035, USA. hrr@med.unc.edu
Monroe
Dougald M
DM
White
Gilbert C
GC
D001778:Blood Coagulation Disorders / Q000188:drug therapy*; D015942:Factor VIIa / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006467:Hemophilia A / Q000188:drug therapy; D002836:Hemophilia B / Q000188:drug therapy; D006470:Hemorrhage / Q000188:drug therapy*; D006801:Humans; D011994:Recombinant Proteins / Q000493:pharmacokinetics / Q000627:therapeutic use; D012449:Safety
D011994:Recombinant Proteins; D015942:Factor VIIa