Semin Thromb Hemost 2006; 32: 022-027
DOI: 10.1055/s-2006-946911
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

New Approaches to Using FEIBA in the Treatment of Inhibitor Patients

Erik Berntorp1 , Alessandro Gringeri2 , Cindy Leissinger3 , Claude Négrier4 , Nigel Key5
  • 1Malmö University Hospital, Malmö, Sweden
  • 2A Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
  • 3Tulane University Medical Center, New Orleans, Louisiana
  • 4Hôpital Edouart Herriot, Centre Régional de Traitement de l'Hémophilie, Lyon, France
  • 5University of Minnesota Medical School, Minneapolis, Minnesota
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Publikationsverlauf

Publikationsdatum:
21. November 2006 (online)

ABSTRACT

Managing hemophilia becomes particularly difficult in patients with inhibitory antibodies, especially in those requiring surgery or with refractory bleeding events. Equally challenging are those patients who develop autoantibodies against factor VIII (FVIII) in the absence of a prior history of FVIII deficiency (acquired hemophilia). Physicians seeking both short- and long-term treatment strategies for bleeding events must often rely on FVIII-bypassing agents such as activated prothrombin complex concentrate (e.g., factor eight bypassing activity [FEIBA VH, Baxter BioScience, Westlake Village, CA]) or recombinant factor VIIa (rFVIIa [NovoSeven, NovoNordisk, Bagsvaerd, Denmark]). Surgical procedures in patients with inhibitors present a considerable challenge, from both a risk-benefit and a cost-benefit aspect. Hemostasis is difficult to achieve in these patients and new treatment options are being explored. Similarly challenging are refractory bleeds, the management of which is likely to benefit from a systematic treatment approach.

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Erik BerntorpM.D. 

Department of Coagulation Disorders, Malmö University Hospital

Malmö, Sweden, SE-20502

eMail: erik.berntorp@med.lu.se