Continuous infusion of coagulation factors: current opinion.
OBJECTIVE
To review the most recent reports on continuous infusion of coagulation factors, focusing on the current issues relating to this mode of therapy.


RESULTS
Continuous infusion has been extensively used as an alternative to intermittent bolus factor replacement since the 1990s. To date, more than 100 reports comprising more than 800 continuous infusion treatments in various clinical situations have been published, with an increase in the current utilization of recombinant coagulation factors. An excellent hemostatic efficacy of continuous infusion has been reported. Continuous infusion protocols, however, still vary widely in terms of the different hemostatic levels targeted, dosage regimens, modes of continuous infusion and duration of therapy, which obviously result in variations in the cost-effectiveness reported by different centers.


CONCLUSIONS
Continuous infusion has been shown to be a safe and cost-effective mode of replacement for treatment of hemophilia. The lack of evidence-based information on the hemostatic levels to be maintained in specific clinical situations, and recent concerns regarding the development of inhibitors, particularly in patients with mild hemophilia treated with continuous infusion, need to be addressed by prospective, randomized studies that compare traditional intermittent injections and the continuous infusion mode of factor replacement.
Batorova
Angelika
A
National Hemophilia Center, University Hospital, Bratislava, Slovak Republic, Israel.
Martinowitz
Uri
U
D001779:Blood Coagulation Factors / Q000008:administration & dosage* / Q000191:economics / Q000493:pharmacokinetics; D005164:Factor IX / Q000008:administration & dosage; D005169:Factor VIII / Q000008:administration & dosage / Q000191:economics / Q000493:pharmacokinetics; D015942:Factor VIIa / Q000008:administration & dosage; D006467:Hemophilia A / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007260:Infusion Pumps / Q000191:economics
D001779:Blood Coagulation Factors; C078147:F8 protein, human; D005169:Factor VIII; D005164:Factor IX; D015942:Factor VIIa