A meta-analysis of the efficacy and safety of recombinant activated factor VII for patients with acute intracerebral hemorrhage without hemophilia.
Hematoma growth is common in intracerebral hemorrhage (ICH) and is associated with a poor outcome for patients. To evaluate the efficacy and safety of recombinant activated factor VII (rFVIIa) used as a hemostatic agent in patients with ICH without hemophilia, we searched Medline, Scopus, the Cochrane Library, Clinicaltrials.gov and the Stroke Trials Directory. Five randomized controlled trials were selected for analysis. Although rFVIIa can reduce the change in ICH volume, there was no significant difference in mortality, modified Rankin Scale (mRS) score or extended Glasgow Outcome Scale (GOS-E) score in patients treated with rFVIIa or placebo. There was a significant increase in arterial thromboembolic adverse events (TAE) in patients treated with rFVIIa. There was an increase in deep vein thrombosis in patients with spontaneous ICH and traumatic ICH. In conclusion, the use of rFVIIa reduces the growth of the hematoma but does not improve patient survival or functional outcome after ICH; in addition, rFVIIa increases the incidence of arterial TAE.
Yuan
Z H
ZH
Department of Emergency, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China.
Jiang
J K
JK
Huang
W D
WD
Pan
J
J
Zhu
J Y
JY
Wang
J Z
JZ
D000208:Acute Disease; D000818:Animals; D002543:Cerebral Hemorrhage / Q000188:drug therapy*; D015942:Factor VIIa / Q000627:therapeutic use*; D015600:Glasgow Coma Scale; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D015201:Meta-Analysis as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D018570:Risk Assessment; D016896:Treatment Outcome
D006490:Hemostatics; D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa