Berntorp E
Malmö University Hospital, Malmö, Sweden.
Haemophilia. 2009 Jan;15(1):3-10. doi: 10.1111/j.1365-2516.2008.01931.x. Epub 2008 Nov 10.
The bypassing agents factor eight inhibitor bypassing activity (FEIBA) anti-inhibitor coagulant complex and recombinant activated factor VII (rFVIIa) have been established as safe and effective therapies for treating bleeding episodes in haemophilia patients with inhibitors. However, the efficacy of each bypassing agent can vary, and neither agent is universally effective. The reasons for such variability have yet to be confirmed, but may involve patient-specific factors and the mechanisms of action (MOAs) and pharmacokinetic profiles of these two agents. This issue underscores the necessity of both products in the comprehensive care of patients with haemophilia and inhibitors. The objective of this review is to discuss the evidence of a differential haemostatic response to bypassing agents and the potential roles of MOA and patient-specific factors in contributing to the differences in response.
旁路制剂八因子抑制剂旁路活性（FEIBA）抗抑制剂凝血复合物和重组活化因子VII（rFVIIa）已被确立为治疗有抑制剂的血友病患者出血发作的安全有效疗法。然而，每种旁路制剂的疗效可能有所不同，且两种制剂都并非普遍有效。这种变异性的原因尚未得到证实，但可能涉及患者特异性因素以及这两种制剂的作用机制（MOA）和药代动力学特征。这个问题凸显了这两种产品在血友病合并抑制剂患者综合护理中的必要性。本综述的目的是讨论对旁路制剂止血反应差异的证据，以及作用机制和患者特异性因素在导致反应差异方面的潜在作用。
