Morfini Massimo
Past President of Italian Association of Haemophilia Centers (AICE), Florence, Italy.
Eur J Haematol. 2016 Feb;96(2):111-8. doi: 10.1111/ejh.12631. Epub 2015 Jul 31.
Recombinant factor VII activated (rFVIIa) is a bypassing agent widely used in haemophilia A and B patients with antibodies against coagulation factors VIII or IX. When used according to the correct doses, rFVIIa may control bleeding, subclinical bleeding and rebleeding, avoiding the effect of neutralising inhibitors. Because of the fast action of the rFVIIa, haemostasis occurs promptly and enables a fast bleeding control with on-demand treatment in home or in surgical setting. Rapidity is also a distinguishing feature in preparation and injection of rFVIIa to cope the restraining times of busy patients and parents. The effective haemostatic activity of rFVIIa enables a sustained bleeding control, which is implemented with every other day (eod) administration and suited for enhanced on-demand therapy and short-term repeated infusions use of rFVIIa to prevent microhaemorrhages or rebleeding. Comprehensive appreciation of these pharmacological and pharmacodynamic' characteristics will likely be a further stimulus to the wider enhanced on-demand use of rFVIIa.
重组活化凝血因子 VII(rFVIIa)是一种旁路制剂,广泛用于患有抗凝血因子 VIII 或 IX 抗体的 A 型和 B 型血友病患者。按照正确剂量使用时,rFVIIa 可控制出血、亚临床出血和再出血,避免中和性抑制剂的影响。由于 rFVIIa 作用迅速,止血能迅速发生,并能在家庭或手术环境中通过按需治疗快速控制出血。快速也是 rFVIIa 制备和注射的一个显著特点,以应对忙碌患者和家长的时间限制。rFVIIa 的有效止血活性可实现持续的出血控制,这通过每隔一天(eod)给药来实现,适用于强化按需治疗以及短期重复输注使用 rFVIIa 以预防微出血或再出血。对这些药理学和药效学特性的全面认识可能会进一步推动 rFVIIa 在更广泛的强化按需使用方面的应用。