Possible Synergy between Recombinant Factor VIIa and Prothrombin Complex Concentrate in Hemophilia Therapy

Possible Synergy between Recombinant Factor VIIa and Prothrombin Complex Concentrate in Hemophilia Therapy
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重组因子 VIIa 和凝血酶原复合物浓缩物在血友病治疗中可能存在的协同作用

DOI:
10.1055/s-0037-1613155
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发表时间:
2002
影响因子:
6.7
通讯作者:
G. Nelsestuen
G. Nelsestuen
中科院分区:
医学2区
文献类型:
--
作者:
N. Key;B. Christie;N. Henderson;G. Nelsestuen

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摘要 重组因子 VIIa(rFVIIa;Novoseven™)用于治疗具有抑制剂的血友病患者。个体之间的临床反应性差异不明确。在美国获得许可之前,rFVIIa 可通过同情使用计划获得,在此研究中描述的两名患者表现出良好的反应。最近,其中一人对 rFVIIa 表现出次优反应。对不同治疗结果的一种可能解释是在同情使用计划中使用凝血酶原复合物浓缩物 (PCC) 序贯治疗,然后使用 rFVIIa。为了支持这一点,一项体外测试表明,该患者在接受 PCC 治疗后将 rFVIIa 添加到全血中时,对 rFVIIa 产生了异常强烈的反应。其他患者的结果支持了这一假设。通过进一步评估,序贯 PCC 和 rFVIIa 相结合的治疗方法可能被证明可用于治疗单独使用任一药物难治性出血。
Summary Recombinant factor VIIa (rFVIIa; Novoseven™) is used for treatment of hemophilia patients with inhibitors. There are poorly defined differences in clinical responsiveness between individuals. Prior to licensure in the United States, rFVIIa was available through the compassionate use program, during which two patients described in this study demonstrated an excellent response. More recently, one of these individuals showed a sub-optimal response to rFVIIa. One possible explanation for different treatment outcomes was sequential therapy with prothrombin complex concentrates (PCC) followed by rFVIIa in the compassionate use program. In support of this, an in vitro test showed that this patient had an exceptionally strong response to rFVIIa when it was added to whole blood after the patient received PCC therapy. Results with other patients supported this hypothesis. With further evaluation, a therapeutic approach combining sequential PCC and rFVIIa may prove useful for treatment of bleeding refractory to either agent used alone.
细胞和因子 VII 的激活。
DOI: 10.1159/000217229
发表时间: 1996
期刊: Haemostasis
影响因子: --
作者:
Rao,LV;Rapaport,SI
通讯作者: Rapaport,SI
活化因子 VII 的可能作用机制不依赖于组织因子。
DOI: --
发表时间: 1998
期刊: Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis.
影响因子: --
作者:
Monroe,DM;Hoffman,M;Oliver,JA;Roberts,HR
通讯作者: Roberts,HR
重组VIIa因子在体内对X因子和凝血酶原的激活是由组织因子介导的。
DOI: 10.1172/jci116691
发表时间: 1993
期刊: The Journal of clinical investigation
影响因子: --
作者:
tenCate,H;Bauer,KA;Levi,M;Edgington,TS;Sublett,RD;Barzegar,S;Kass,BL;Rosenberg,RD
通讯作者: Rosenberg,RD