Hedner Ulla
University of Lund, Sweden.
Curr Opin Hematol. 2007 May;14(3):225-9. doi: 10.1097/MOH.0b013e3280dce57b.
To examine the development of recombinant FVIIa (rFVIIa); a new concept of inducing hemostasis. It was developed for use in hemophilia patients with inhibitors against FVIII or FIX with the vision to provide these patients with a therapeutical option to be used instead of FVIII or FIX. For the first time it was shown that pharmacological doses of FVIIa induced hemostasis.
Hemostasis was achieved by rFVIIa in major surgery (repeated doses) as well as in a home-treatment setting (one single injection) in severe hemophilia patients with inhibitors. A recent study indicates that rFVIIa may be useful as prophylaxis. In heavily bleeding nonhemophilia patients rFVIIa was shown to induce hemostasis. Pharmacological doses of rFVIIa enhance thrombin generation on activated platelets resulting in the formation of tight hemostatic fibrin plugs resistant against premature proteolysis. High doses of rFVIIa seem to be safe probably due to its localized effect.
Pharmacological doses of rFVIIa induce hemostasis in severe hemophilia and in nonhemophilia patients with profuse, heavy bleeding. rFVIIa enhances thrombin generation on activated platelets, thereby initiating the formation of strong, tight fibrin hemostatic plugs resistant to premature lysis. It also seems to be safe in high doses.
探讨重组凝血因子VIIa（rFVIIa）的发展历程，这是一种诱导止血的新概念。它专为患有抗FVIII或FIX抑制剂的血友病患者而研发，旨在为这些患者提供一种可替代FVIII或FIX的治疗选择。首次证明药理剂量的FVIIa可诱导止血。
在患有抑制剂的严重血友病患者中，rFVIIa在大手术（重复给药）以及家庭治疗环境（单次注射）中均实现了止血。最近一项研究表明，rFVIIa可能可用作预防用药。在严重出血的非血友病患者中，rFVIIa被证明可诱导止血。药理剂量的rFVIIa可增强活化血小板上的凝血酶生成，从而形成紧密的、抗过早蛋白水解的止血纤维蛋白凝块。高剂量的rFVIIa似乎是安全的，这可能归因于其局部作用。
药理剂量的rFVIIa可在严重血友病患者以及有大量严重出血的非血友病患者中诱导止血。rFVIIa可增强活化血小板上的凝血酶生成，从而启动形成强大、紧密且抗过早溶解的纤维蛋白止血凝块。高剂量使用时似乎也是安全的。
