Journal of Thrombosis and Haemostasis · 2013 · 33 citations · 25 references
MedicinePharmacokineticsPharmacologyClinical PharmacologyHemostasisPharmacodynamicsCoagulation AbnormalitiesCoagulation CascadeCoagulation DisordersCoagulation PhysiologyHemostatic AgentsCoagulation Factor Replacement TherapyFactor ViiaHemostatic EfficacyPharmacokinetic-pharmacodynamic Link ModelingRecombinant Activated Factor ViiRecombinant Fusion ProteinsThrombin Generation AssaysThrombin Inhibition
BACKGROUND: Recombinant factor VIIa (rFVIIa) is approved for use in controlling bleeding episodes in people with hemophilia who have developed inhibitors to replacement therapy. Due to its short half-life (t½), frequent injections are required, limiting its use as a prophylactic treatment. A novel, recombinant fusion protein linking coagulation factor VIIa with albumin (rVIIa-FP) has been developed to extend the t(½) of rFVIIa. OBJECTIVES: The aim of our studies was to investigate the pharmacokinetic/pharmacodynamic characteristics of rVIIa-FP in preclinical animal species. METHODS: Pharmacokinetic (PK) parameters were derived after single intravenous dosing in hemophilia A mice, rats, rabbits and monkeys. PK analysis was based on human FVII plasma levels determined by measuring FVII antigen levels by ELISA in mice and rats, and FVIIa activity using STACLOT® VIIa-rTF in rabbits and monkeys. Induction of thrombin generation was investigated in mice, while hemostatic activity was assessed by thrombus formation in rabbits. RESULTS: Compared with rFVIIa, rVIIa-FP displayed a prolonged t(½), enhanced in vivo recovery and reduced clearance in all species investigated. In mice, 16 h after treatment with rVIIa-FP, thrombin levels were quantifiable, indicating prolonged efficacy, whereas values had approached baseline at this time after treatment with rFVIIa. After 12 h, hemostatic efficacy was negligible in rFVIIa-treated rabbits, but sustained in animals receiving rVIIa-FP. CONCLUSIONS: These studies indicate that the longer t(½) of rVIIa-FP compared with rFVIIa translates into extended activity. These findings suggest that rVIIa-FP has the potential to be administered less frequently than rFVIIa-containing concentrates in clinical use.
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Hematological Problems in Pediatric Intensive Care
Shoshana Revel‐Vilk, Peter N. Cox, Nancy Robitaille et al. · Pediatric and adolescent medicine · 2013 · 3.5K citations
Factor VIII Products and Inhibitor Development in Severe Hemophilia A
Samantha C. Gouw, Johanna G. van der Bom, Rolf Ljung et al. · New England Journal of Medicine · 2013 · 436 citations · Full text
Medicine, Hematology, Pediatrics +16
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