Secondary prophylaxis with factor IX concentrates: continuous infusion.
Haemophilia patients may require prolonged treatment during peri-operative period or life-threatening bleedings. Intermittent bolus infusions of factor concentrates have been used successfully for many years. However, pharmacokinetics may vary among products and patients, and the wide fluctuations in factor levels during therapy can make management inaccurate and unsafe. Specific protocols for continuous infusion have been developed, which may decrease factor utilization, facilitate laboratory monitoring of factor levels, and may decrease the overall cost of therapy. Continuous infusion of different clotting factor concentrates (factor VIII, factor IX, porcine factor VIII, rFVIIa, and activated prothrombin complex concentrates) has been associated with excellent haemostasis and safety: indeed, by continuous infusion unsafe low troughs or dangerous high concentrations can be avoided. In this review, the pharmacokinetic aspects of the continuous infusion of plasma-derived and recombinant factor IX concentrates are showed. Finally, the advantages and disadvantages of continuous infusion are discussed.
Morfini
Massimo
M
Agenzia per l'Emofilia, Azienda Ospedaliero Universitaria Careggi, Firenze, Italia. m.morfini@dac.unifi.it
D001779:Blood Coagulation Factors / Q000008:administration & dosage* / Q000276:immunology / Q000302:isolation & purification / Q000493:pharmacokinetics / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002405:Catheterization, Central Venous; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D005164:Factor IX / Q000008:administration & dosage* / Q000302:isolation & purification / Q000493:pharmacokinetics / Q000627:therapeutic use; D006207:Half-Life; D002836:Hemophilia B / Q000150:complications / Q000188:drug therapy*; D006470:Hemorrhage / Q000517:prevention & control*; D006801:Humans; D007262:Infusions, Intravenous; D007518:Isoantibodies / Q000096:biosynthesis; D008657:Metabolic Clearance Rate; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D010949:Plasma; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000302:isolation & purification / Q000493:pharmacokinetics / Q000627:therapeutic use; D055502:Secondary Prevention
D001779:Blood Coagulation Factors; D007518:Isoantibodies; D011994:Recombinant Proteins; C025667:prothrombin complex concentrates; C093388:Mononine; D005164:Factor IX