Continuous infusion of recombinant activated factor vii (rfviia) for treatment of high titer inhibitor patients

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Due to the short half-life of rFVIIa (NovoSeven), continuous infusion (CI) is an attractive administration method for prolonged treatments in inhibitor (INH) patients. However, the optimal maintenance dose and the adequate monitoring are still debated. This Italian survey on the use of rFVIIa CI provided data on 22 INH patients (4 children aged 2-5 yrs and 18 adults aged 24-76 yrs), 19 with hemophilia A and 3 with acquired inhibitors (INH peak: 16-4,096 BU/ml). All 29 courses started with a median bolus dose of 100 Hg/Kg (range: 90-150) immediately followed by CI. CI was given using minipumps (Walkmed 440-350 PIC) in 20 courses and syringe-pumps in 9. Parallel infusion with saline was adopted in 25/29 courses. Tranexamic acid was associated in 12/29 courses. One-stage FVII:C assay was used to monitor rFVIIa CI. The median CI rate adopted was 16 ng/Kg/hr (range 10-50) in courses of 1-34 days (median 7). For major surgery the median CI rate was slightly higher (19 (ig/Kg/hr, range: 15-50) compared to minor surgery (median 13, range 10-20). FVII:C levels were always above 5 U/ml, ranging from 6 to 70 U/ml (median 14). FVII clearance was widely ranging from 32 to 138 ml/Kg/hr (median of 57). Children had significantly higher values of rFVIIa clearance compared to the adults (median: 95 vs 55 ml/Kg/hr, p

Original languageEnglish
Issue number11 PART I
Publication statusPublished - 2000

ASJC Scopus subject areas

  • Hematology


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