The effect of activated prothrombin-complex concentrate (FEIBA) on joint and muscle bleedings in patients with haemophilia A with an inhibitor to Factor VIII

1982 ◽  
pp. 93-100
Author(s):  
J. L. van Geijlswijk
Keyword(s):  
Factor Viii ◽  
Prothrombin Complex Concentrate ◽  
Haemophilia A ◽  
Activated Prothrombin Complex Concentrate

Use of an Activated Prothrombin Complex Concentrate (Auto Factor IX-Hyland) in the Control of Bleeding of Haemophilic (A) Patients with Inhibitor of Factor VIII

1979 ◽  
Author(s):  
E.J. Watson-Williams ◽  
C.F. Abildgaard ◽  
E. A. Turner
Keyword(s):  
Soft Tissue ◽  
Factor Viii ◽  
Prothrombin Complex Concentrate ◽  
Factor Ix ◽  
Factor Viii Inhibitor ◽  
Activated Prothrombin Complex Concentrate ◽  
Prolonged Aptt ◽  
Bleeding Episodes ◽  
Viii Inhibitor ◽  
Flow Study

One of us (C.F.A.) has previously reported the successful use of one of the commercially available prothrombin complex concentrates for the control of bleeding episodes of haemophiltc patients with factor VIII inhibitors. Subsequent batches of these concentrates have not proved consistently effective even in doses of 150 factor IX units/kg every 24 hours. Recently an investigational preparation, Auto Factor IX, has been made available to us. This has a stated factor VIII correctional unit assay for each batch, (based on the ability to correct the prolonged APTT of plasma containing an inhibitor of factor VIII). We used 60-120 units/kg as an IV dose every 12 or 24 hours in the treatment of 24 bleeding episodes in 8 patients with factor VIII Inhibitor. The bleeding episodes were haemarthrosis (12) soft-tissue (6) intralingual (2) lacerations (2) retroperitoneal (1) and epidural (1). Rapid easing of pain and reduction of swelling was noted in all joints and soft tissue bleeds. In the retroperitoneal bleed cessation of bleeding was demonstrated by Technetium 99 Sulfur-colloid flow study, in the patient with epidural bleeding the hematoma was shown to reduce by serial CAT scans. Response was as good as we have come to expect from similar levels of factor VIII concentrate given to patients without an inhibitor. In 23 of the 24 episodes there was a marked reduction of APTT 10 minutes after the completion of the infusion.

scholarly journals Anti-inhibitor Coagulant Complex (Autoplex) for treatment of factor VIII inhibitors in hemophilia

Blood ◽  
1980 ◽  
Vol 56 (6) ◽  
pp. 978-984 ◽  
Author(s):  
CF Abildgaard ◽  
JA Penner ◽  
EJ Watson-Williams
Keyword(s):  
Soft Tissue ◽  
Factor Viii ◽  
Prothrombin Complex Concentrate ◽  
Activated Partial Thromboplastin Time ◽  
Minor Bleeding ◽  
Puncture Wound ◽  
Monitoring Therapy ◽  
Concurrent Use ◽  
Activated Prothrombin Complex Concentrate ◽  
Bleeding Episodes

Abstract Fourteen individuals with severe hemophilia complicated by factor VIII inhibitors (1 to 132 Bethesda Units) were treated for 33 bleeding episodes with a new activated prothrombin complex concentrate, Anti- Inhibitor Coagulant Complex (Autoplex, Hyland, Glendale, Calif.). Excellent or good results were observed in 21 of 25 minor bleeding episodes treated, which included joint, soft tissue, and mucous membrane hemorrhages. Eight major bleeding problems (an epidural bleed, a puncture wound, 2 serious soft tissue hemorrhages, 2 lacerations, and 2 major surgical procedures) were treated with excellent (6) or good (2) results. No serious complications were encountered, but two children developed transient hypofibrinogenemia following Autoplex infusion. Although some shortening of the prothrombin time and activated partial thromboplastin time was noted after infusion of Autoplex, there is no useful laboratory test for monitoring therapy. Despite the unknown mechanism of action for bypassing factor VIII, Autoplex appears to be a useful and needed interim product and is safe and effective. In view of the possible potentiation of thrombosis concurrent use of fibrinolytic inhibitors should be avoided.

Sequential Infusion of rFVIIa and Plasma-Derived Activated Prothrombin Complex Concentrate In Haemophilia A Paediatric Patient with Inhibitors

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4660-4660
Author(s):  
Giuseppe Lassandro ◽  
Francesco Antonio Scaraggi ◽  
Rosanna Scaraggi ◽  
Teresa Capriati ◽  
Domenico De Mattia ◽  
...  
Keyword(s):  
Prothrombin Complex Concentrate ◽  
Conflicts Of Interest ◽  
Coagulation Factors ◽  
High Titre ◽  
Left Knee ◽  
Haemophilia A ◽  
Activated Prothrombin Complex Concentrate ◽  
End Of Treatment ◽  
Inhibitor Titre ◽  
Bypassing Agents

Abstract Abstract 4660 One of the serious complication in hemophilia therapy is the development of high titre inhibitors to FVIII and less often to others coagulation factors. It makes treatment of bleeds very challenging. We report a case of hemarthrosis in hemophilia A pediatric patient with inhibitors, treated with sequential infuson of rFVIIa (rFVIIa, NOVOSEVEN; Novo Nordisk A/S, Bagsvaerd, Denmark) and plasma activated prothrombin complex concentrate (pd- aPCC, FEIBA; Baxter AG Vienna Austria). rFVIIa and plasma activated prothrombin complex concentrate are, indeed, used as haemostatic bypassing agents to prevent eaemorrages, with the goal of limiting sequelae as arthropathy, or to control quickly heamostasis as intensive on–demand treatment. A 3 years old male patient affected by haemophilia A with inhibitors came to our observation for a traumatic hemarthrosis of the left knee. Clinic examination showed swelling and pain. His inhibitor titre was 29 Bethesda Units. First we infused rFVIIa for seven consecutive days at the dose of 90 ug/kg every 3 hours. This therapy didn't determinate any clinical improvement. Then we infused plasma activated prothrombin complex concentrate for the next consecutive seven days at the dose of 60 UI/kg every 12 hours. At the end of treatment we noticed pain disappearance and reducing swelling. Medical literature recently describes similar paediatric cases treated with sequential infusion of rFVIIa and plasma activated prothrombin complex concentrate. Our positive experience could stimulate to use haemostatic bypassing agents because apparently safe. We encourage to use this therapeutic scheme because it seem to reduce healing times of acute events. Disclosures: No relevant conflicts of interest to declare.

scholarly journals The Effect of Non-Activated Prothrombin Complex Concentrate (Proplex ST) on Intraperitoneal Hematoma in a Hemophilia A Patient with a Factor VIII Inhibitor.

1996 ◽  
Vol 35 (4) ◽  
pp. 319-322 ◽  
Author(s):  
Hideo KAGAWA ◽  
Minori YASUZAWA ◽  
Yoshio OZAKI ◽  
Yoshihisa YAMAMOTO ◽  
Tatsuya KATSURADA ◽  
...  
Keyword(s):  
Factor Viii ◽  
Prothrombin Complex Concentrate ◽  
Hemophilia A ◽  
Factor Viii Inhibitor ◽  
Activated Prothrombin Complex Concentrate ◽  
Viii Inhibitor

Effect of Treatment with Activated Prothrombin Complex Concentrate (FEIBA) on Factor VIII-Antibody Level

1978 ◽  
Vol 40 (02) ◽  
pp. 478-485 ◽  
Author(s):  
K Lechner ◽  
Ch Nowotny ◽  
B Krinninger ◽  
M Zegner ◽  
E Deutsch
Keyword(s):  
Factor Viii ◽  
Antibody Level ◽  
Prothrombin Complex Concentrate ◽  
Anamnestic Response ◽  
Activated Prothrombin Complex Concentrate ◽  
Inhibitor Level ◽  
Complex Preparation ◽  
Effect Of Treatment ◽  
High Doses ◽  
Stimulation Of

SummaryThe influence of treatment with an activated prothrombin complex preparation (FEIBA) on the antibody level was studied in 10 haemophiliacs with an antibody to factor VIII. The antibody level was observed to rise at least once in five patients, while in the remaining five patients no rise occurred. In all, 6 out of 31 treatments were followed by an anamnestic rise of the antibody level, corresponding to 19.4%. A rise of the inhibitor level following FEIBA treatment is likely to occur in patients who show a marked antibody rise after factor VIII treatment (good responders), but have a low antibody level at the time of treatment. High doses of FEIBA and simultaneous transfusion of red cells may also enhance the likelihood of an anamnestic response. Stimulation of antibody production is probably due to the presence of small amounts of factor VIII in this preparation.

A decade-long clinical experience on the prophylactic use of activated prothrombin complex concentrate in acquired haemophilia A

2018 ◽  
Vol 29 (3) ◽  
pp. 282-287 ◽  
Author(s):  
Anita Árokszállási ◽  
Katalin Rázsó ◽  
Péter Ilonczai ◽  
Zsolt Oláh ◽  
Zsuzsanna Bereczky ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Prothrombin Complex Concentrate ◽  
Haemophilia A ◽  
Acquired Haemophilia ◽  
Activated Prothrombin Complex Concentrate ◽  
Prophylactic Use
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