P L Turecek1, Katalin Váradi1, B. Keil1, Claude Négrier2, Erik Berntorp3, Jan Astermark3, Jean‐Claude Bordet2, Massimo Morfini4, Silvia Linari4, HP Schwarz1
1Baxter BioScience, Vienna, Austria
2Hôpital Edouard Herriot, Lyon, France
3University Hospital Malmö, Malmö, Sweden
4Azienda Ospedaliera Careggi, Florence, Italy
Tóm tắt
Factor VIII (FVIII)-bypassing agents have complex modes of action but all control bleeding in inhibitor patients by triggering the generation of thrombin. No routine test is available for monitoring this therapy in patients with inhibitors against FVIII. We present an assay that records FEIBA- or FVIIa-mediated changes in thrombin generation (TG) in FVIII inhibitor plasma samples. In plasma samples spiked with FEIBA TG was normalized above 0.4 U/ml, while for recombinant FVIIa (rFVIIa) more than 12.5 µg/ml were required to induce TG in the absence of tissue factor (TF). Addition of TF increased the TG potential of rFVIIa in vitro. This assay seems suitable for monitoring the pharmacokinetics of inhibitor bypassing agents during treatment and possibly for predicting responses to treatment.
