Invasive procedures and minor surgery in factor VII deficiency

Women with congenital factor VII deficiency: clinical phenotype and treatment options from two international studies

“…As bleeding complications only occurred during the first 24 postoperative hours and baseline FVII:C levels did not help to predict bleeding (all <1%), the analysis restricted to the early RT period showed that nonbleeders were given a higher first dose (at least 22 µg/kg) and no less than two doses in comparison to those patients who had bled. These findings highlight the importance of using a sufficiently effective RT schedule during the first 24 postoperative hours to prevent postoperative bleeding [26,27].…”

Factor VII Deficiency: Clinical Phenotype, Genotype and Therapy

“…Results from multicenter observational studies like STER and IRF7 have provided important elements of evidence related to the efficacy and safety of replacement therapy (RT) as well as the schedules for spontaneous bleeding episodes [15], major surgery [38], invasive procedures [39] and prophylaxis [16]. These trials have contributed to prediction of the bleeding risk of patients with inherited FVII deficiency mainly based on the first bleeding symptom, the personal clinical history, and FVII:c levels [14].…”

“…For invasive procedures and minor surgery, 1-day RT resulted sufficient, with an “average” total dose of rFVIIa of 20 μg/kg/body weight, possibly in more than one administration [39]. RT with rFVIIa has a very good safety-to-efficacy ratio [38,39,44,45]. Continuous infusion of rFVIIa during surgery has also been reported as effective, safe, and well-tolerated in patients with inherited Factor VII deficiency [46].…”

Use of low-dose recombinant factor VIIa in a pregnant patient with factor VII deficiency undergoing a minor surgery

“…Majority of patients with this rare bleeding disorder are asymptomatic and diagnosed incidentally. [7] We also administered a prophylactic dose of 9.3 µg/kg (total 1 mg) followed by the second dose same as the first one 4 h later despite absence of bleeding. [3] Recombinant activated factor VIIa dose and duration have not been clearly determined although it is commonly used.…”