Document Detail

Individualization of bypassing agent treatment for haemophilic patients with inhibitors utilizing thromboelastography.
MedLine Citation:
PMID:  17083509     Owner:  NLM     Status:  MEDLINE    
The treatment of bleeding for haemophilic patients with inhibitors relies on the use of the bypassing agents, recombinant factor VIIa and factor eight inhibitor bypass activity (FEIBA). While both therapies are effective in the majority of bleeding episodes, there is a significant amount of interindividual variability when it comes to the response to therapy. As of yet, there is no reliable laboratory parameter that can predict the response to therapy in the same manner that factor VIII and factor IX levels predict response in non-inhibitor patients. Developing such a laboratory parameter is vital in order to maximize the clinical efficacy of these agents. Thromboelastography (TEG) is a device, which assesses clot formation over time in whole blood and has several characteristics which suggest it may be an effective way to monitor bypass agent therapy. We studied the ability of TEG to individualize the treatment regimens of three patients with high titre inhibitors assessing the response to recombinant factor VIIa, FEIBA, and when both were used sequentially. The TEG allowed for individualization of treatment for each of the three patients and resulted in more effective, convenient and less expensive treatment regimens. We thus believe that TEG is a promising device for monitoring of bypass agent therapy and should be studied further.
G Young; R Blain; P Nakagawa; D J Nugent
Related Documents :
17415129 - Use of recombinant factor viia during excision of vascular anomalies.
20159179 - A randomized prospective trial comparing the levonorgestrel-releasing intrauterine syst...
18218579 - Fatal cytomegalovirus gastrointestinal disease in an infant with wiskott-aldrich syndrome.
18346679 - Epidemiology of acute upper gastrointestinal bleeding.
9254089 - Absence of bleeding complications in patients undergoing cortical surgery while receivi...
12709699 - Prophylactic clip application does not decrease delayed bleeding after colonoscopic pol...
6532539 - Prevention and management of urinary tract infections following endoscopic and urologic...
12563199 - Long-term outcome of infrainguinal bypass grafting in patients with serologically prove...
22387729 - Dual energy ct in gout: a prospective validation study.
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Haemophilia : the official journal of the World Federation of Hemophilia     Volume:  12     ISSN:  1351-8216     ISO Abbreviation:  Haemophilia     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-06     Completed Date:  2007-05-29     Revised Date:  2009-10-21    
Medline Journal Info:
Nlm Unique ID:  9442916     Medline TA:  Haemophilia     Country:  England    
Other Details:
Languages:  eng     Pagination:  598-604     Citation Subset:  IM    
Department of Hematology, Children's Hospital of Orange County, Orange, CA 92868, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Factor VIII / therapeutic use*
Factor X / therapeutic use*
Hemophilia A / drug therapy*
Hemophilia B / drug therapy*
Hemostatics / therapeutic use*
Recombinant Proteins / therapeutic use*
Thrombelastography / methods*
Reg. No./Substance:
0/Hemostatics; 0/Recombinant Proteins; 9001-27-8/Factor VIII; 9001-29-0/Factor X

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Application of current knowledge to the management of bleeding events during immune tolerance induct...
Next Document:  Influence of factor VIII on overall coagulability and fibrinolytic potential of haemophilic plasma a...