Activated Recombinant Human Coagulation Factor VII Therapy for Intracranial Hemorrhage in Patients with Hemophilia A or B with Inhibitors

Arkin, Steven; Cooper, Herbert A.; Hutter, Jörg; Miller, Scott T.; Schmidt, Michael; Seibel, Nita L.; Shapiro, Amy D.; Warrier, Indira

doi:10.1159/000022418

Cited by 60 publications

(58 citation statements)

References 13 publications

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“…After vascular damage and local initiation of the coagulation cascade, rFVIIa enhances thrombin generation on the surface of activated platelets, leading to the formation of a stable, lysis-resistant plug at the site of vessel injury. 9 rFVIIa has been successfully used to control intracranial hemorrhage in patients with hemophilia or other coagulation disorders, 10,11 and can arrest intraoperative bleeding and reverse coagulopathies in patients undergoing neurosurgical procedures. 12 rFVIIa has also been reported to prevent or minimize refractory bleeding in noncoagulopathic patients.…”

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confidence: 99%

Safety and Feasibility of Recombinant Factor VIIa for Acute Intracerebral Hemorrhage

Mayer

Brun

Broderick

et al. 2005

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232

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Background and Purpose-Hematoma growth occurs in 38% of intracerebral hemorrhage (ICH) patients scanned by computed tomography (CT) within 3 hours of onset. Activated recombinant factor VII (rFVIIa) promotes hemostasis at sites of vascular injury and may minimize hematoma growth after ICH. Methods-In this randomized, double-blind, placebo-controlled, dose-escalation trial, 48 subjects with ICH diagnosed within 3 hours of onset were treated with placebo (nϭ12) or rFVIIa (10, 20, 40, 80, 120, or

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mentioning

confidence: 99%

Safety and Feasibility of Recombinant Factor VIIa for Acute Intracerebral Hemorrhage

Mayer

Brun

Broderick

et al. 2005

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232

134

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“…In der Literatur sind einige Fälle von intrakraniellen Blutung bei kongenitalen Hämophilien, welche ebenfalls mit Hemmkörpern assoziiert sein können, und anderen angeborenen Gerinnungsstörungen beschrieben [1,3,7]. Bezüg-lich einer erworbenen Hämophilie mit Hemmkörpern handelt es sich unseres Wissens nach bei dem einzigen publizierten Fall um ein Neugeborenes, das 5 Tage nach der Geburt aufgrund eines Faktor-VIII-Mangels mit Hemmkörpern, den die Mutter während der Schwangerschaft entwickelt hat, eine intrakranielle Blutung erlitten hat [8].…”

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Intrakranielle Blutung bei erworbener Hemmkörperhämophilie

et al. 2006

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Acquired hemophilia is a rare complication in autoimmune disorders and malignancies. It can result in bleedings into skin and muscle, whereas intracranial hemorrhage in adults has so far not been described. We report a patient with acute intracerebral hemorrhage due to acquired hemophilia with factor VIII inhibition. The patient was treated with recombinant factor VIIa and open hematoma evacuation followed by administration of cortisone and cyclophosphamide. After good initial recovery, intracerebral rebleeding occurred and the patient died from brainstem compression.

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“…Reasons cited were experience with the use of rFVIIa in such situation(s) [11], safety, lack of anamnesis, small infusion volume, and efficacy. Because many of the children have a central venous catheter for prior rFVIII or rFIX prophylaxis, venous access did not appear to be an issue.…”

Section: How Should Central Nervous System (Cns) Hemorrhage Be Managementioning

confidence: 99%

Therapeutic choices for patients with hemophilia and high‐titer inhibitors

et al. 2001

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Effective treatment of bleeding episodes in hemophilia with high titer inhibitors (HTI) remains a challenge, despite the fact that the therapeutic armamentarium has expanded considerably over the past few years. Treatment safety has improved with the availability of porcine factor VIII (FVIII) and bypassing products such as recombinant factor VIIa (rFVIIa), and plasma-derived activated Prothrombin Complex Concentrates (aPCCs) that are virally inactivated. The major drawbacks of rFVIIa and aPCCs are their unpredictable hemostatic effect, lack of laboratory assays to monitor efficacy and dosing frequency, and the risk of thrombosis. The proceedings of a one-day workshop of physicians who specialized in treating patients with hemophilia held in Vienna on May 13, 2000 have been summarized. In making a decision regarding the choice of product, physicians often consider the type of bleeding episode (life or limb threatening), age of the patient, volume of the reconstituted product, previous exposure to plasma derived products, cost, efficacy, and safety. For plasma naïve patients, to achieve rapid hemostasis a majority of the panelists used porcine FVIII (for patients who lack porcine inhibitory antibodies) or rFVIIa. For patients previously treated with plasma derived factors, in addition to the above concentrates, aPCCs were recommended. Although no data exists regarding safety and efficacy, switching products was routinely practiced either because of availability or cost. Furthermore, the panelists were uncertain about the efficacy of bypassing agents in the prevention of joint disease in inhibitor patients. The workshop participants felt that future research offers the best solution to resolve some of the dilemmas faced by clinicians and may help individualise treatment in a hemophilia patient with a high titer inhibitor. Am. J. Hematol. 67:240-246, 2001.

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Activated Recombinant Human Coagulation Factor VII Therapy for Intracranial Hemorrhage in Patients with Hemophilia A or B with Inhibitors

Cited by 60 publications

References 13 publications

Safety and Feasibility of Recombinant Factor VIIa for Acute Intracerebral Hemorrhage

Safety and Feasibility of Recombinant Factor VIIa for Acute Intracerebral Hemorrhage

Intrakranielle Blutung bei erworbener Hemmkörperhämophilie

Therapeutic choices for patients with hemophilia and high‐titer inhibitors

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