Effects of factor VIII inhibitor bypassing activity (FEIBA), recombinant factor VIIa or both on thrombin generation in normal and haemophilia A plasma

Haemophilia - Tập 14 Số 4 - Trang 782-786 - 2008
Gili Kenet1, Uri Martinowitz2, Ariella Zivelin3, Uri Seligsohn3
1The Amalia Biron Research Institute of Thrombosis and Hemostasis, Chaim Sheba Medical Centre, Tell Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
2The National Hemophilia Centre, Chaim Sheba Medical Centre, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
3The Amalia Biron Research Institute of Thrombosis and Hemostasis

Tóm tắt

Summary.  Factor VIII inhibitor bypass activity (FEIBA) and recombinant factor VIIa (rFVIIa) are the common bypassing agents for treating haemophilia A or haemophilia B patients who developed an inhibitor to factor VIII or IX, respectively. As these preparations differ in their composition and mode of action, combined therapy, either sequential or simultaneous has recently been used for achieving haemostasis during bleeding episodes in patients who became refractory to FEIBA or rFVIIa when each was given alone. In this in vitro study, we show by a sensitive assay of thrombin generation that phospholipids present in FEIBA and other procoagulants contribute to FEIBA’s activity and that exogenous phospholipids are essential for the activity of rFVIIa. We also demonstrate that the combination of FEIBA and rFVIIa has a marked synergistic effect on thrombin generation in plasma of a haemophilia A patient with a high titre of an inhibitor. It is conceivable that simultaneous administration of small doses of FEIBA and rFVIIa may be beneficial in treating haemophilia A patients, with an inhibitor to FVIII, who are resistant to conventional therapy.

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Tài liệu tham khảo

10.1111/j.1365-2516.2004.00912.x

10.1111/j.1365-2516.2007.01451.x

10.1055/s-0037-1613155

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10.1111/j.1538-7836.2005.01683.x

10.1055/s-0037-1613868

10.1016/0049-3848(84)90047-1

10.1055/s-0037-1613110

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Thông tin xuất bản

Haemophilia

Tập 14 Số 4

782-786

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