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Related Experiment Videos

Recombinant activated factor VII as a universal haemostatic agent

U Hedner1

  • 1Novo Nordisk A/S, Health Care Discovery, Gentofte, Denmark. uhe@novo.dk

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|November 18, 1998
PubMed
Summary

Recombinant factor VIIa (rFVIIa) effectively induces haemostasis in patients with severe bleeding disorders, including hemophilia and rare factor deficiencies. It also shows promise in managing bleeding in thrombocytopenia and other conditions by leveraging its interaction with tissue factor and platelets.

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Area of Science:

  • Hematology
  • Biochemistry
  • Pharmacology

Background:

  • Hemostasis, the cessation of bleeding, is primarily initiated by the tissue factor (TF) and activated factor VII (FVIIa) complex.
  • Recombinant FVIIa (rFVIIa) is an active form of factor VII that facilitates hemostasis upon binding to TF exposed after tissue damage.

Purpose of the Study:

  • To evaluate the efficacy of rFVIIa in inducing hemostasis across various bleeding conditions.
  • To explore the potential of rFVIIa in patients with hemophilia, factor VII deficiency, liver disease, warfarin use, thrombocytopenia, Glanzmann's thrombasthenia, and von Willebrand disease.

Main Methods:

  • Clinical assessment of hemostatic efficacy in patients with life- and limb-threatening bleeding.
  • Administration of rFVIIa to patients with congenital factor deficiencies, liver disease, thrombocytopenia, and specific platelet disorders.

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  • Observation of bleeding time and acute bleed management.

    • Main Results:

    • rFVIIa demonstrated a 76-84% efficacy rate in hemophilia patients refractory to other treatments.
    • It normalized prothrombin time in patients with liver disease and those on warfarin.
    • rFVIIa shortened bleeding time in 50% of thrombocytopenia patients and was effective in managing acute bleeds.
    • Successful treatment was observed in patients with Glanzmann's thrombasthenia and Type III von Willebrand disease.

    Conclusions:

    • rFVIIa is a valuable therapeutic agent for inducing hemostasis in diverse bleeding disorders.
    • Its mechanism, involving TF binding and platelet interaction, offers a broad application in managing bleeding, even in patients without primary coagulation defects.