Further understanding of recombinant activated factor VII mode of action.
Recombinant activated factor VII (rFVIIa) is being increasingly used to treat bleeding associated with a variety of non-hemophilic coagulopathic indications, and its mechanism of action in these areas is under active investigation. Numerous studies have shown that FVIIa binds with low affinity to activated platelets; rFVIIa can subsequently enhance platelet-surface thrombin generation by activating factor (F) X and by contributing additional FIXa to the hemostatic process. This FIXa can rapidly activate additional FX, which may explain why non-hemophilic coagulopathic bleeds respond to lower doses of rFVIIa than do hemophilic bleeds. However, the platelet surface may be able to process only a limited amount of FXa, accounting for the observation that some models of non-hemophilic coagulopathy show a plateau in the effect of rFVIIa.
Division of Hematology/Oncology, Department of Medicine, Center for Thrombosis and Hemostasis, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7035, USA. dmonroe@med.unc.edu
Dougald M
DM
Monroe
D001791:Blood Platelet Disorders / Q000188:drug therapy / Q000503:physiopathology; D020147:Coagulation Protein Disorders / Q000188:drug therapy / Q000503:physiopathology; D015942:Factor VIIa / Q000009:adverse effects / Q000494:pharmacology*; D006487:Hemostasis; D006801:Humans; D011994:Recombinant Proteins / Q000009:adverse effects / Q000494:pharmacology
D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa