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Titolo:
Continuous infusion of recombinant factor VIIa in patients with haemophilia and inhibitors - Experience in the Netherlands and Belgium.
Autore:
Mauser-Bunschoten, EP; de Goede-Bolder, A; Wielenga, JJ; Levi, M; Peerlinck, K;
Indirizzi:
Univ Utrecht Hosp, Utrecht, Netherlands Univ Utrecht Hosp Utrecht Netherlands trecht Hosp, Utrecht, Netherlands Univ Rotterdam Hosp, Rotterdam, Netherlands Univ Rotterdam Hosp Rotterdam Netherlands Hosp, Rotterdam, Netherlands Sophia Childrens Hosp, Rotterdam, Netherlands Sophia Childrens Hosp Rotterdam Netherlands osp, Rotterdam, Netherlands Hosp Dijkzigt, Rotterdam, Netherlands Hosp Dijkzigt Rotterdam Netherlands sp Dijkzigt, Rotterdam, Netherlands Acad Med Ctr, Amsterdam, Netherlands Acad Med Ctr Amsterdam NetherlandsAcad Med Ctr, Amsterdam, Netherlands Katholieke Univ Leuven Hosp, Louvain, Belgium Katholieke Univ Leuven HospLouvain Belgium uven Hosp, Louvain, Belgium
Titolo Testata:
NETHERLANDS JOURNAL OF MEDICINE
fascicolo: 6, volume: 53, anno: 1998,
pagine: 249 - 255
SICI:
0300-2977(199812)53:6<249:CIORFV>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
MODEL-INDEPENDENT METHODS; HEMOPHILIA-A; PHARMACOKINETICS; FIBRINOLYSIS; THROMBIN;
Keywords:
recombinant factor VIIa; continuous infusion; haemophilia inhibitor patients; internal bleeding; surgical interventions; administration method;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
18
Recensione:
Indirizzi per estratti:
Indirizzo: Mauser-Bunschoten, EP Univ Utrecht Hosp, Utrecht, Netherlands Univ UtrechtHosp Utrecht Netherlands Netherlands
Citazione:
E.P. Mauser-Bunschoten et al., "Continuous infusion of recombinant factor VIIa in patients with haemophilia and inhibitors - Experience in the Netherlands and Belgium.", NETH J MED, 53(6), 1998, pp. 249-255

Abstract

Background: Initial clinical experience with recombinant factor VIIa (rVIIa) for treatment of haemophilia patients with inhibitors against factor VIII or IX has been obtained by administration of rVIIa by repeated intravenous bolus injections. However, continuous infusion of rVIIa may be a more appropriate administration method if prolonged treatment is indicated. Methods: We have surveyed and analysed the initial experience with continuous infusion of rVIIa in the Netherlands and Belgium. Results: Five hospitals treated 7 haemophilia patients with inhibitors on 9 different occasions (4 bleedings, 5 surgical interventions) by continuousinfusion of rVIIa over a total of 59 days. Haemostatic coverage was considered effective in 8 out of 9 cases and partially effective in 1 case. Continuous infusion of rVIIa was aimed at rVIIa target plasma levels of 10 U/ml and a decrease in prothrombin time (PT) of 3 s compared to control levels. This was obtained by an initial bolus injection of 90 mu g/kg prior to continuous infusion of rVIIa at doses between 30-6 mu g/kg/h (mean 17.5 mu g/kg/h). A conventional one-stage factor VII coagulation assay, often used in combination with a PT, was satisfactory in monitoring rVIIa treatment. The additional clinical value of anti-fibrinolytic and anti-thrombophlebitic treatment was unclear. Conclusion: In our experience, rVIIa appeared to be efficacious and safe when administered by continuous infusion. Continuous infusion of rVIIa is more convenient than bolus injections of rVIIa, easy to monitor and provides a cost reduction of > 50%, These advantages make continuous infusion an attractive administration method for prolonged treatment with rVIIa. (C) 1998 Elsevier Science B.V. All rights reserved.

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Documento generato il 29/09/20 alle ore 04:31:43