Dimichele D, Négrier C
New York Presbyterian Weill Cornell Center, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, NY 10021, USA.
Haemophilia. 2006 Jul;12(4):352-62. doi: 10.1111/j.1365-2516.2006.01284.x.
Patients with haemophilia who develop inhibitors have unique treatment needs; bypassing agents such as Factor Eight Inhibitor Bypassing Activity, Anti-Inhibitor Coagulant Complex (FEIBA; Baxter AG, Vienna, Austria) are part of this therapeutic armamentarium. This study sought to increase comprehension of the full therapeutic profile of FEIBA by evaluating its safety and efficacy in the settings of acute bleeding, surgery, and prophylaxis. Information was collected through a postmarketing surveillance study; questionnaire booklets were distributed to 72 treatment centers in the United States and Europe. The booklets contained questions related to patient demographics, inhibitor titre determinations, and FEIBA treatment. Information comprising 200 FEIBA treatment periods and representing >4500 infusions was available for 63 patients with inhibitors (n = 60, haemophilia A; n = 3, haemophilia B). Twelve patients were in more than one treatment group. Efficacy was determined by a subjective global evaluation and was good or excellent in 82% of all acute, and 91% of all surgical, treatments. Additionally, prophylactic treatment resulted in improved or stabilised clinical orthopaedic status in 11 of 13 patients (85%). Based on available data, FEIBA was judged safe in all treatment situations by the small number of adverse events (<0.04%). No thrombotic complications occurred during any treatment episode. Results indicated that FEIBA was safe and effective in acute, surgical, and prophylactic treatment settings, supporting the utility of FEIBA as a treatment option for patients with inhibitors. However, prospective studies are advised.
产生抑制物的血友病患者有独特的治疗需求;旁路制剂如八因子抑制物旁路活性制剂、抗抑制物凝血复合物(FEIBA;百特公司,奥地利维也纳)是这一治疗手段的一部分。本研究旨在通过评估FEIBA在急性出血、手术和预防中的安全性和有效性,加深对其完整治疗概况的理解。信息通过一项上市后监测研究收集;向美国和欧洲的72个治疗中心分发了问卷手册。手册包含与患者人口统计学、抑制物滴度测定和FEIBA治疗相关的问题。63例有抑制物的患者(n = 60,甲型血友病;n = 3,乙型血友病)提供了包含200个FEIBA治疗周期且代表>4500次输注的信息。12例患者分属多个治疗组。疗效通过主观整体评估确定,在所有急性治疗中82%良好或优秀,在所有手术治疗中91%良好或优秀。此外,预防性治疗使13例患者中的11例(85%)的临床骨科状况得到改善或稳定。根据现有数据,由于不良事件数量少(<0.04%),FEIBA在所有治疗情况下被判定为安全。在任何治疗期间均未发生血栓形成并发症。结果表明,FEIBA在急性、手术和预防性治疗环境中安全有效,支持将FEIBA作为有抑制物患者的一种治疗选择。然而,建议进行前瞻性研究。