Journal of Clinical Investigation · 1983 · 239 citations · 23 references
MedicineHematologyPharmacotherapyHemostasisImmunopathologyTransfusion MedicineAnticoagulant TherapyAnticoagulation TherapyCoagulation Factor DeficienciesHemostatic AgentsHemostatic DisordersTranexamic Acid UseAlloantibody FormationBypassing Agent TherapyFactor ViiaFactor Viii ActivationFactor Viii PhysiologyJoint Mobility RestorationRecombinant Activated Factor ViiTranexamic Acid Administration
Two patients with hemophilia A complicated with high-titer alloantibodies have been treated by repeated infusions of microgram quantities of pure human Factor VIIa. Patient 1 was presented with a gastrocnemius muscle bleeding that involved the knee joint. Upon treatment with Factor VIIa the circumference of the muscle decreased and joint mobility increased substantially. Patient 2 was given Factor VIIa concurrent with tranexamic acid in association with the extraction of two primary molars. No significant gingival bleeding occurred after Factor VIIa and tranexamic acid treatment. Furthermore, no deleterious side effects or increase of the alloantibody level were observed in either patient throughout the Factor VIIa infusion. These results, although limited and preliminary in nature, suggest that trace quantities of Factor VIIa can act as a Factor VIII bypassing activity and restore hemostasis in these patients.
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A More Uniform Measurement of Factor VIII Inhibitors
Carol K. Kasper, Louis M. Aledort, David L. Aronson et al. · Thrombosis and Haemostasis · 1975 · 587 citations
Lisbeth J. M. Sjamsoedin, L. Heijnen, Eveline P. Mauser‐Bunschoten et al. · New England Journal of Medicine · 1981 · 308 citations