TY - JOUR
T1 - Recombinant factor VIIa
T2 - Safety and efficacy
AU - Goodnough, Lawrence T.
AU - Shander, Aryeh S.
PY - 2007/9
Y1 - 2007/9
N2 - PURPOSE OF REVIEW: Recombinant factor VIIa has been increasingly used to provide hemostasis in nonapproved indications. This trend has resulted in concerns about safety, efficacy and costs. RECENT FINDINGS: Recombinant factor VIIa seems to have hemostatic effects in posttrauma and perisurgery excessive bleeding, although further studies are required. Recombinant factor VIIa may be used to reverse the effect of warfarin or other vitamin K-antagonist therapy following vitamin K administration. Some beneficial effects have also been suggested in a limited number of patients with liver disease and hemorrhagic stroke. Recombinant factor VIIa should be used with caution in cases with known hypercoagulability, excessive bleeding in the setting of disseminated intravascular coagulation or other states of generalized activation of the hemostatic system. In most of the nonapproved cases, a 4.8-mg vial administered to an adult patient weighing 50-100 kg to achieve a 50-100 μg/kg dose is recommended. SUMMARY: While consensus recommendations on the use of recombinant factor VIIa in nonapproved settings have been developed, more studies are needed to define dose and timing in these diverse patient populations. For now, decisions about off-label use of recombinant factor VIIa remain at the physician's discretion, assisted by hospital pharmacotherapeutic or transfusion committees.
AB - PURPOSE OF REVIEW: Recombinant factor VIIa has been increasingly used to provide hemostasis in nonapproved indications. This trend has resulted in concerns about safety, efficacy and costs. RECENT FINDINGS: Recombinant factor VIIa seems to have hemostatic effects in posttrauma and perisurgery excessive bleeding, although further studies are required. Recombinant factor VIIa may be used to reverse the effect of warfarin or other vitamin K-antagonist therapy following vitamin K administration. Some beneficial effects have also been suggested in a limited number of patients with liver disease and hemorrhagic stroke. Recombinant factor VIIa should be used with caution in cases with known hypercoagulability, excessive bleeding in the setting of disseminated intravascular coagulation or other states of generalized activation of the hemostatic system. In most of the nonapproved cases, a 4.8-mg vial administered to an adult patient weighing 50-100 kg to achieve a 50-100 μg/kg dose is recommended. SUMMARY: While consensus recommendations on the use of recombinant factor VIIa in nonapproved settings have been developed, more studies are needed to define dose and timing in these diverse patient populations. For now, decisions about off-label use of recombinant factor VIIa remain at the physician's discretion, assisted by hospital pharmacotherapeutic or transfusion committees.
KW - Bleeding
KW - Efficacy
KW - Recombinant factor VIIa
KW - Safety
UR - http://www.scopus.com/inward/record.url?scp=34748860267&partnerID=8YFLogxK
U2 - 10.1097/MOH.0b013e32826388c3
DO - 10.1097/MOH.0b013e32826388c3
M3 - Review article
C2 - 17934358
AN - SCOPUS:34748860267
SN - 1065-6251
VL - 14
SP - 504
EP - 509
JO - Current Opinion in Hematology
JF - Current Opinion in Hematology
IS - 5
ER -