von Willebrand factor content in Alphanate<sup>®</sup>

Logan, L. J.

doi:10.1111/j.1365-2516.2008.01859.x

Cited by 2 publications

(2 citation statements)

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“…The plasma‐derived von Willebrand factor (VWF) containing FVIII concentrates Fanhdi ® and Alphanate ® were obtained from Grifols, Barcelona, Spain and Haemate ® (Humate‐P), from CSL Behring, King of Prussia, PA, USA. The VWF:FVIII ratio is close to 1 in Fanhdi ® and Alphanate ® and 2·5 in Haemate ® (Ristol et al , 1996; Berntorp, 2009; Logan, 2009). Human thrombin was obtained from ERL Enzyme Research Lab, Dia‐Service, Gothenburg, Sweden.…”

Section: Methodsmentioning

confidence: 89%

“…Analysis of the interactions between APCC and the FVIII products show that the combination of the preparations potentiates each other in a synergistic way, resulting in a significant increase in thrombin production for all products apart from for Alphanate ® ( P = 0·1470). Alphanate ® , Haemate ® and Fanhdi ® are all plasma‐derived concentrates that contain VWF (Ristol et al , 1996; Berntorp, 2009; Logan, 2009). It was previously shown that the immunoreactivity appears to be higher towards Advate ® compared with Haemate ® and Fanhdi ® in plasmas with inhibitors directed mainly to light chain epitopes, resulting in decreased thrombin generation (Salvagno et al , 2007).…”

Section: Discussionmentioning

confidence: 99%

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Combination of FVIII and by‐passing agent potentiates in vitro thrombin production in haemophilia A inhibitor plasma

2010

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Summary The by‐passing agents, recombinant activated factor VII (rFVIIa) and activated prothrombin complex concentrate (APCC), are important tools in the treatment of patients with haemophilia A and high‐responding inhibitory antibodies. It has been observed clinically that in some patients undergoing immune tolerance induction the bleeding frequency decreases, hypothetically caused by a transient haemostatic effect of infused FVIII not measurable ex vivo. We evaluated how by‐passing agents and factor VIII (FVIII) affect thrombin generation (TG) in vitro using plasma from 11 patients with severe haemophilia A and high titre inhibitors. Samples were spiked with combinations of APCC, rFVIIa and five different FVIII products. Combination of APCC and FVIII showed a synergistic effect in eliciting TG (P < 0·005) for four FVIII products. When rFVIIa and FVIII were combined the interaction between the preparations was found to be additive. APCC and rFVIIa were then combined without FVIII, resulting in an additive effect on thrombin production. Each product separately increased TG above baseline. In conclusion, the amount of thrombin formed in vitro by adding a by‐passing agent, was higher in the presence of FVIII. Our findings support the use of FVIII in by‐passing therapy to optimize the haemostatic effect.

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Section: Methodsmentioning

confidence: 89%