Continuous infusion of recombinant porcine factor VIII for neurosurgical management of intracranial haemorrhage in a patient with severe haemophilia A with factor VIII inhibitor

Acquired haemophilia A, concomitant acute myocardial infarction and urgent major surgery: How to successfully treat a critical patient with rpFVIII (Obizur®)

“…Despite the recommended initial dose of concentrate is 200 IU/kg [5], we have decided to treat the patient with a lower dosage due to concomitant presence of an AMI, thus ensuring a sufficient plasmatic FVIII level, but preventing him from reaching too high and potentially dangerous peaks. In literature only few cases of patients with congenital haemophilia A undergoing surgery under rpFVIII coverage has been published [7,8], while ours is the first real-world report that deals with the history of an AHA patient undergoing a major surgery under successfully susoctocogalfa coverage.…”

“…Surgery is always at haemorrhagic risk, but in case of a subject with AHA this risk is very increased. In literature, in addition to the cases of patients with congenital haemophilia undergoing surgery [7,8], there have been no reports of surgeries carried out under coverage of Obizur® in subjects with AHA. The complete resolution of the AHA provides for the eradication of the autoantibodies against the endogenous FVIII that has formed and which is the basis of acute bleeding in patients suffering from this acquired disorder.…”

The Use of Bypassing Treatment Strategies in Hemophilia and Their Effect on Laboratory Testing

“…4 Another therapeutic option, recombinant porcine FVIII, although not technically a BPA, is currently approved for use in patients with acquired (autoimmune) HA 5 ; case reports have shown successful use in congenital HA and either low titer or absent cross-reacting porcine FVIII inhibitors. 6,7 A novel approach to managing hemophilia with or without inhibitors is the use of nonfactor agents that are either approved for clinical use (emicizumab, Hemlibra) or in clinical trials including fitusiran, 8 concizumab, 9 marstacimab, 10 and SerpinPC 11,12 (see ►Table 1).…”