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.

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

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.

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 Incidence of immune responses following 102 infusions of autoplex in 18 hemophilic patients with antibody to factor VIII

Blood ◽  
1984 ◽  
Vol 63 (2) ◽  
pp. 457-462
Author(s):  
Y Laurian ◽  
JP Girma ◽  
T Lambert ◽  
D Meyer ◽  
MJ Larrieu
Keyword(s):  
Immune Responses ◽  
Factor Viii ◽  
Prothrombin Complex Concentrate ◽  
Hemophilia A ◽  
Significant Rise ◽  
Predisposing Factor ◽  
Anamnestic Response ◽  
Activated Prothrombin Complex Concentrate ◽  
Bleeding Episodes ◽  
High Responders

An activated prothrombin complex concentrate (Autoplex) was infused for the treatment of 102 bleeding episodes in 18 hemophilia A patients with antibody to factor VIII who were previously known as high responders. Among 95 bleeding episodes treated with a single infusion of the concentrate [43–107 factor VIII correcting units (FECU)/kg], only 1 anamnestic response was observed. On the contrary, a significant rise in antibody titer occurred following 2 of 4 double (at 8–12 hr interval) and all 3 multiple (over3 –10 days) infusions of Autoplex. The occurrence of immune responses may be explained by the presence of factor VIII coagulant antigen (VIII:CAg) in the 26 batches of Autoplex tested by two-site immunoradiometric assay (10-–36 U/vial). The anamnestic response was not correlated to the batch used nor to the amount (0.6–7.8 U/kg/day) of VIII:CAg infused per day. However, exposure to the concentrate over several days appeared to be the major predisposing factor for an immune response.

scholarly journals Incidence of immune responses following 102 infusions of autoplex in 18 hemophilic patients with antibody to factor VIII

Blood ◽  
1984 ◽  
Vol 63 (2) ◽  
pp. 457-462 ◽  
Author(s):  
Y Laurian ◽  
JP Girma ◽  
T Lambert ◽  
D Meyer ◽  
MJ Larrieu
Keyword(s):  
Immune Responses ◽  
Factor Viii ◽  
Prothrombin Complex Concentrate ◽  
Hemophilia A ◽  
Significant Rise ◽  
Predisposing Factor ◽  
Anamnestic Response ◽  
Activated Prothrombin Complex Concentrate ◽  
Bleeding Episodes ◽  
High Responders

Abstract An activated prothrombin complex concentrate (Autoplex) was infused for the treatment of 102 bleeding episodes in 18 hemophilia A patients with antibody to factor VIII who were previously known as high responders. Among 95 bleeding episodes treated with a single infusion of the concentrate [43–107 factor VIII correcting units (FECU)/kg], only 1 anamnestic response was observed. On the contrary, a significant rise in antibody titer occurred following 2 of 4 double (at 8–12 hr interval) and all 3 multiple (over3 –10 days) infusions of Autoplex. The occurrence of immune responses may be explained by the presence of factor VIII coagulant antigen (VIII:CAg) in the 26 batches of Autoplex tested by two-site immunoradiometric assay (10-–36 U/vial). The anamnestic response was not correlated to the batch used nor to the amount (0.6–7.8 U/kg/day) of VIII:CAg infused per day. However, exposure to the concentrate over several days appeared to be the major predisposing factor for an immune response.

scholarly journals The use of factor eight inhibitor by-passing activity (FEIBA immuno) product for treatment of bleeding episodes in hemophiliacs with inhibitors

Blood ◽  
1983 ◽  
Vol 61 (1) ◽  
pp. 36-40 ◽  
Author(s):  
MW Hilgartner ◽  
GL Knatterud
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Side Effects ◽  
Soft Tissue ◽  
Factor Viii ◽  
Surgical Procedures ◽  
Factor Ix ◽  
Mucous Membranes ◽  
Bleeding Episodes ◽  
Inhibitor Titer

FEIBA (factor eight inhibitor by-passing activity) Immuno was used to achieve hemostasis in 46 patients with factor VIII inhibitors with titers greater than 4 Bethesda units, and 3 patients with factor IX inhibitors. One-hundred and sixty-five bleeding episodes were treated with 50–70 U/kg; 102 of these episodes occurred in joints. 20 in mucous membranes, 33 muscle and soft tissue, and 10 were emergency episodes including 3 central nervous system and 4 surgical procedures. Ninety- three percent of the bleeding episodes were controlled, while 7% were not controlled: 36% were controlled by one infusion in 12 hr, another 42% with 1 or more infusions in 36 hrs and an additional 14% were controlled in more than 36 hr. There were no serious side effects, and while the inhibitor titer rose in 10 of the patients, the product continued to be efficacious.

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.

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