Experiences with continuous infusion of recombinant activated factor VII

Blood Coagul Fibrinolysis. 1998 Mar:9 Suppl 1:S97-101.

Abstract

A questionnaire was sent to 28 haemophilia treatment centres known to have used recombinant activated factor VII (rFVIIa; NovoSeven, Novo Nordisk, Bagsvaerd, Denmark), to collect data on continuous infusion of this product. This mode of administration was recently introduced for rFVIIa but there are several questions which remain to be answered in order to optimize this technique. Of the 26 responding centres, 14 had used rFVIIa in continuous infusion for 40 treatment episodes over a total of 283 days. In most of the cases the treatment was targeted at a factor VII level of 10 IU/ml, monitored by the one-stage clotting assay. This seemed to be adequate for most of the haemorrhagic and surgical procedures. Pretreatment pharmacokinetic evaluation was performed in only a minority of the cases but is probably of great importance given the wide variation observed in the clearance values. A strategy was necessary to prevent local thrombophlebitis, at least for infusions in peripheral veins; parallel infusion of heparin, saline or dextrose-saline proved effective. The question of optimal monitoring needs further attention. Haemorrhagic complications were significantly less frequent when treatment was combined with the antifibrinolytic tranexamic acid.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Multicenter Study

MeSH terms

  • Drug Monitoring
  • Factor VIIa / adverse effects
  • Factor VIIa / pharmacokinetics
  • Factor VIIa / therapeutic use*
  • Hemophilia A / drug therapy*
  • Hemophilia A / metabolism
  • Hemorrhage / chemically induced
  • Humans
  • Infusion Pumps
  • Metabolic Clearance Rate
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / pharmacokinetics
  • Recombinant Proteins / therapeutic use
  • Surveys and Questionnaires
  • Thrombophlebitis / chemically induced

Substances

  • Recombinant Proteins
  • Factor VIIa