Document Detail


Possible synergy between recombinant factor VIIa and prothrombin complex concentrate in hemophilia therapy.
MedLine Citation:
PMID:  12152680     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recombinant factor VIIa (rFVIIa; Novoseven) is used for treatment of hemophilia patients with inhibitors. There are poorly defined differences in clinical responsiveness between individuals. Prior to licensure in the United States, rFVIIa was available through the compassionate use program, during which two patients described in this study demonstrated an excellent response. More recently, one of these individuals showed a sub-optimal response to rFVIIa. One possible explanation for different treatment outcomes was sequential therapy with prothrombin complex concentrates (PCC) followed by rFVIIa in the compassionate use program. In support of this, an in vitro test showed that this patient had an exceptionally strong response to rFVIIa when it was added to whole blood after the patient received PCC therapy. Results with other patients supported this hypothesis. With further evaluation, a therapeutic approach combining sequential PCC and rFVIIa may prove useful for treatment of bleeding refractory to either agent used alone.
Authors:
Nigel S Key; Beverly Christie; Nicole Henderson; Gary L Nelsestuen
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Thrombosis and haemostasis     Volume:  88     ISSN:  0340-6245     ISO Abbreviation:  Thromb. Haemost.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-08-02     Completed Date:  2003-08-18     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7608063     Medline TA:  Thromb Haemost     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  60-5     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Minnesota, Minneapolis, USA. nelse002@tc.umn.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Coagulation Factors / administration & dosage*
Blood Coagulation Tests
Drug Synergism
Drug Therapy, Combination
Factor VII / administration & dosage*
Factor VIIa
Female
Hemophilia A / drug therapy*
Hemorrhage / drug therapy
Humans
Male
Middle Aged
Prothrombin / administration & dosage
Recombinant Proteins / administration & dosage*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P01-HL65578/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Blood Coagulation Factors; 0/Recombinant Proteins; 0/recombinant FVIIa; 37224-63-8/prothrombin complex concentrates; 9001-25-6/Factor VII; 9001-26-7/Prothrombin; EC 3.4.21.21/Factor VIIa

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


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