Fernandez Maximilian, Yu Tabitha, Bjornson Erik, Luu Huong, Spotts Gerald
Baxter BioScience, Westlake Village, California 91362, USA.
Blood Coagul Fibrinolysis. 2006 Apr;17(3):165-71. doi: 10.1097/01.mbc.0000220236.92219.08.
Continuous infusion of factor VIII (FVIII) concentrates during surgical procedures offers the potential for improved hemostatic control and reduced FVIII consumption, but requires stable FVIII concentrates. The stability of ADVATE, Antihemophilic Factor (Recombinant), Plasma/Albumin-Free Method (rAHF-PFM), was examined using various simulated conditions. Experiments performed with a multi-therapy 6060 pump showed FVIII recoveries of 95% or more after 48 h for multiple lots of high-potency and mid-potency rAHF-PFM, with or without heparin. Non-infused controls maintained at the same temperature showed similar FVIII recovery, demonstrating that the infusion system did not cause loss of FVIII activity. Supportive data generated using single lots of mid-potency or high-potency rAHF-PFM infused through a MEDEX or HARVARD syringe pump, or a CADD Pump-1, demonstrated FVIII recoveries of 83% or more at 24 or 48 h under all conditions tested. Additionally, rAHF-PFM was stable immediately after dilution in saline or saline/dextrose solutions, and after a 10-h exposure to ultraviolet and visible light. Taken together, these data demonstrate that rAHF-PFM is stable under conditions typically encountered during continuous infusion, and suggest that rAHF-PFM should be safe and effective when used for FVIII replacement by continuous infusion in patients with hemophilia A.
在外科手术过程中持续输注凝血因子VIII(FVIII)浓缩物有可能改善止血控制并减少FVIII消耗,但需要稳定的FVIII浓缩物。使用各种模拟条件检测了ADVATE(重组抗血友病因子,无血浆/白蛋白方法,rAHF-PFM)的稳定性。使用多疗法6060泵进行的实验表明,对于多批高效和中效rAHF-PFM,无论有无肝素,48小时后FVIII回收率均达到95%或更高。在相同温度下保存的未输注对照显示出相似的FVIII回收率,表明输注系统未导致FVIII活性丧失。使用单批中效或高效rAHF-PFM通过MEDEX或哈佛注射器泵或CADD Pump-1进行输注所产生的支持性数据表明,在所有测试条件下,24或48小时时FVIII回收率均达到83%或更高。此外,rAHF-PFM在盐溶液或盐溶液/葡萄糖溶液中稀释后以及在紫外线和可见光下暴露10小时后立即保持稳定。综上所述,这些数据表明rAHF-PFM在连续输注过程中通常遇到的条件下是稳定的,并表明rAHF-PFM在用于A型血友病患者的连续输注FVIII替代治疗时应是安全有效的。