title: Comparison of bypassing agents in bleeding reduction in treatment of bleeding episodes in patients with haemophilia and inhibitors.
abstract: BACKGROUND
  Mild-to-moderate bleeding disorders in haemophilia are primarily treated via recombinant activated factor VII a (rFVIIa) or activated prothrombin complex concentrate (aPCC). However, the efficacy of each bypassing agents may vary and none of them is universally effective.
  
  
  METHODS
  After reviewing the databases of PubMed, Scopus, MD Consult, Ovid, Trip database, Google Scholar, ProQuest and the Cochrane Library, finally, 17 papers published from 2000 to 2013 were extracted. We used as a random effect model in meta-analysis. Comprehensive meta-analysis (CMA) software was used for calculating and estimating the mean of bleeding reduction and performing meta-analysis.
  
  
  RESULTS
  The mean of bleeding reduction in aPCC and rFVIIa were 71.2% with CI 95% (lower limit 86.8% and upper limit 82%) and 72.3% with CI 95% (lower limit 57.6% and upper limit 83.4%), respectively.
  
  
  CONCLUSIONS
  Although differences between the two products were very close to each other, they reported similar effects on joint bleeds. Further clinical studies should be performed by incorporating a standardized measurement in comparative efficacy of aPCC and rFVIIa.
authors.affiliation: School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mina
authors.initials: M
authors.lastname: Golestani
authors.affiliation: Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Peyman
authors.initials: P
authors.lastname: Eshghi
authors.affiliation: School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Rasekh
authors.affiliation: School of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Abdol Majid
authors.initials: AM
authors.lastname: Cheraghali
authors.affiliation: School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Salamzadeh
authors.affiliation: Iranian Center of Excellence in Health Management, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Imani
keywords: Bleeding; Haemophilia; Meta-Analysis