Clinical study of recovery and half‐life of vapor‐heated factor VII concentrate

Rivard, Georges E.; Kováč, Ivan; Kunschak, M; Thöne, P. M.

doi:10.1046/j.1537-2995.1994.341195065036.x

Cited by 16 publications

(10 citation statements)

References 12 publications

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“…A much greater proportion of an injected dose of FVII than of another Gla‐containing protein, prothrombin, partitions to the extravascular space [18]. Even though the clearance of FVII from the plasma is much faster than that of prothrombin (plasma half‐life of 5–6 h for FVII [19] vs. 2–3 days for prothrombin [20]), the whole body fractional catabolic rate of FVII is less than that of prothrombin [18]. These data suggest that FVII has an extended residence time outside the vascular space, although they do not prove that this is a result of its binding to TF in the extravascular space.…”

Section: Discussionmentioning

confidence: 99%

Tissue factor around dermal vessels has bound factor VII in the absence of injury

Hoffman

Colina

McDonald

et al. 2007

Journal of Thrombosis and Haemostasis

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Summary. Background: ÔIdlingÕ or ongoing low-level activity of the tissue factor (TF) pathway is a postulated mechanism by which the coagulation process can become active without a lag period at sites of injury. Objective: To determine whether TF around cutaneous vessels has bound factor VIIa in the absence of injury, and thus could participate in the idling process. Methods: Immunostaining of mouse skin with antibodies against a 15-residue peptide from the sequence of mouse TF, and against the whole extracellular portion of TF. Results: The whole TF antibody recognized TF in squamous epithelium and around vessels in the dermis. By contrast, the monospecific antibody only recognized TF in the squamous epithelium, but not around vessels. We also found that biotinylated, active siteinhibited FVIIa (FVIIai) bound to tissue sections in the same areas in which TF was recognized by the monospecific antibody (squamous epithelium), but did not bind around vessels. Molecular modeling revealed that FVIIa and FX binding to TF masked a significant part of the surface of the target peptide. Conclusions: In the aggregate, these data are most consistent with the interpretation that TF in perivascular sites has bound FVIIa, even in the absence of any injury. The presence of endogenously bound FVIIa prevents the subsequent binding of the monospecific antibody or exogenous FVIIai to perivascular TF.

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Section: Discussionmentioning

confidence: 99%

Tissue factor around dermal vessels has bound factor VII in the absence of injury

Hoffman

Colina

McDonald

et al. 2007

Journal of Thrombosis and Haemostasis

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“…Our report describes a series of seven surgical procedures in two patients severely de®cient in FVII in whom haemostasis was successfully obtained by a recombinant activated FVII product that was injected every 6 h. A prior pharmacokinetic investigation had revealed that the trough value of FVII:C was in the range of 0.30±0.50 U mL 71 , at which level loss of haemostatic function was not suspected. The half-life of FVIIa has been determined at 2.5±3 h, but the literature contains quite inconsistent information regarding the in vivo half-life of FVII ranging from 4 h [8] or less [9] to 5.3 h [10]. The half-lives of FVIIa and FVII may be quite similar.…”

Section: Discussionmentioning

confidence: 99%

Use of recombinant factor VIIa in surgery in factor‐VII‐deficient patients

et al. 1997

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Patients suffering from severe factor VII deficiency may present with serious bleeding problems. No clear guidelines exist regarding therapy in such patients in case of a large bleeding or surgery. Indeed, it has been postulated that some patients with severe factor VII deficiency may never present with overt bleeding problems. However, in factor-VII-deficient patients who have previously demonstrated a clinical tendency to bleed, surgery is expected to cause excessive bleeding. We present two females suffering from a severe factor VII deficiency (FVII:C < 0.01 U mL(-1) ) with a distinct history of haemorrhagic diathesis. Due to recurrent bleeding in the past, or for circumstantial reasons, surgery was demanded over a 4-year period on a total of seven occasions. To assist haemostasis during and after joint surgery on five occasions and for embolization and subsequent removal of a large haemangioma of the occipital region, recombinant factor VIIa (NovoSeven) was utilized in doses approximating 20 μg kg(-1) b.w. every 6 h beginning immediately before surgery and continued until 30 h to 13 days postoperatively, depending of the size of the respective procedure. Using this approach, we observed normal haemostasis, and there were no signs of excessive postoperative bleeding or wound haematoma. No adverse reactions or side-effects were observed, and there were no complaints or clinical signs indicative of thrombotic complications. As judged from the clinical course of these seven minor and major surgeries, recombinant factor VIIa appears to be highly efficaceous and safe in the treatment patients with severe factor VII deficiency undergoing surgery.

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“…Factor VII concentrates: Plasma-derived FVII concentrates ( 5 BPL Elstree, UK and Baxter) have been successfully used to manage patients with FVII deficiency with spontaneous bleeds; for patients undergoing a variety of surgical procedures and for prophylaxis against bleeds in children with severe FVII deficiency [93][94][95]. These products are virally inactivated to reduce the risk of viral transmission.…”

Section: Currently Available Treatmentsmentioning

confidence: 99%

The rare coagulation disorders – review with guidelines for management from the United Kingdom Haemophilia Centre Doctors' Organisation

et al. 2004

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Summary.The rare coagulation disorders are heritable abnormalities of haemostasis that may present significant difficulties in diagnosis and management. This review summarizes the current literature for disorders of fibrinogen, and deficiencies of prothrombin, factor V, FV + VIII, FVII, FX, the combined vitamin K-dependent factors, FXI and FXIII. Based on both collective clinical experience and the literature, guidelines for management of bleeding complications are suggested with specific advice for surgery, spontaneous bleeding, management of pregnancy and the neonate. We have chosen to include a section on Ehlers-Danlos Syndrome because haematologists may be consulted about bleeding manifestations in such patients.

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Clinical study of recovery and half‐life of vapor‐heated factor VII concentrate

Cited by 16 publications

References 12 publications

Tissue factor around dermal vessels has bound factor VII in the absence of injury

Tissue factor around dermal vessels has bound factor VII in the absence of injury

Use of recombinant factor VIIa in surgery in factor‐VII‐deficient patients

The rare coagulation disorders – review with guidelines for management from the United Kingdom Haemophilia Centre Doctors' Organisation

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