Reversal of Warfarin-Induced Excessive Anticoagulation with Recombinant Human Factor VIIa Concentrate

Deveras, Ruby Anne E.

doi:10.7326/0003-4819-137-11-200212030-00009

Cited by 252 publications

(133 citation statements)

References 15 publications

Supporting

Mentioning

120

Contrasting

Unclassified

Order By: Relevance

“…Excessive Warfarin Associated Bleeding A case series of 13 patients with critically prolonged INR and bleeding complications due to warfarin showed that they were treated successively and rapidly in all patients, regardless of rFVIIa dose (range, 15-90 lg/kg of body weight) [21]. Indications for use of rFVIIa were an INR [10 in high-risk persons (n = 5), clinical hemorrhage (n = 4), and diagnostic or therapeutic procedures (n = 4).…”

Section: Bleeding In Liver Diseasesmentioning

confidence: 99%

Rational Use of Recombinant Factor VIIa in Clinical Practice

Dutta

Verma

2013

Indian J Hematol Blood Transfus

View full text Add to dashboard Cite

In the United States, the FDA-approved indications for recombinant factor VIIa is for bypassing inhibitors to factors VIII and IX in patients with hemophilia A and B respectively and for treatment of congenital factor VII deficiency. In European countries, rFVIIa is licensed for the above indications as well as for Glanzmann's thrombasthenia. In absence of high-quality data favoring off-label use of this agent and laboratory test to predict response to this agent, and in view of high cost of rFVIIa, off-label use of recombinant factor VIIa should be restricted to only when hemorrhage has not responded to transfusion or other conventional therapy. It appears, two such conditions where recombinant factor VIIa may be beneficial are traumatic and postpartum hemorrhages.

show abstract

Section: Bleeding In Liver Diseasesmentioning

confidence: 99%

Rational Use of Recombinant Factor VIIa in Clinical Practice

Dutta

Verma

2013

Indian J Hematol Blood Transfus

View full text Add to dashboard Cite

show abstract

“…Our truncated doses of RVIIa concentrate may be critical in this safety context since it appears that the thrombogenic potential for RFVIIa inindividuals without an underlying congenital or iatrogenic coagulopathy may be doserelated [26]. Furthermore, there are two published anecdotal reports of rapid, successful, and uncomplicated reversal of active bleeding associated with LMWH administered for cardiac ischemia [12,13] and multiple descriptions of uncomplicated reversal of warfarin-induced hemorrhage [11].…”

Section: Discussionmentioning

confidence: 99%

Reversal of low-molecular-weight heparin-induced bleeding in patients with pre-existing hypercoagulable states with human recombinant activated factor VII concentrate

2006

Self Cite

View full text Add to dashboard Cite

Low-molecular-weight heparins are widely employed in prophylactic and therapeutic antithrombotic regimens for venous thromboembolic events. Excessive anticoagulation with lowmolecular-weight heparins rarely can precipitate catastrophic bleeding complications. Currently, there is no specific or reliable antidote that can reverse the anticoagulant effects of low-molecular-weight heparins efficiently and safely. This report describes three individuals with underlying hypercoagulable states, who developed clinically significant bleeding complications while receiving therapeutic anticoagulation with enoxaparin. All of the hemorrhagic events subsequently were safely and effectively reversed with a single intravenous bolus infusion of recombinant activated factor VIIa (RFVIIa) concentrate. Hemoglobins, prothrombin times, and clinical overt bleeding were monitored before and after the administration of RFVIIa. In all three cases, bleeding was controlled without an increase in thrombotic events. Our findings demonstrate that RFVIIa can rapidly and safely reverse the hemorrhagic adverse effects associated with excessive levels of low-molecular-weight heparin in patients with pre-existing hypercoagulable conditions and/or acute venous thromboembolism. Am. J. Hematol. 81:582-589, 2006. V V C 2006 Wiley-Liss, Inc.

show abstract

“…Thus, vitamin K administration is not an adequate treatment for patients with CVA as well as any major hemorrhage supported by LVAD, either. Several studies demonstrated the effect of recombinant activated factor VII on warfarin reversal and reported successful results treating CVH events (Deveras RAE et al, 2002). Although recombinant activated factor VII does reverse the INR, it does not lead to complete reversal of all aspects of warfarin associated coagulopathy.…”

Section: Management Of Cva After Pulsatile Extracorporeal Lvadmentioning

confidence: 99%