Document Detail


Individualization of bypassing agent treatment for haemophilic patients with inhibitors utilizing thromboelastography.
MedLine Citation:
PMID:  17083509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
G Young; R Blain; P Nakagawa; D J Nugent
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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    
Affiliation:
Department of Hematology, Children's Hospital of Orange County, Orange, CA 92868, USA. gyoung@choc.org
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MeSH Terms
Descriptor/Qualifier:
Factor VIII / therapeutic use*
Factor X / therapeutic use*
Hemophilia A / drug therapy*
Hemophilia B / drug therapy*
Hemostatics / therapeutic use*
Humans
Male
Recombinant Proteins / therapeutic use*
Thrombelastography / methods*
Chemical
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


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