Recombinant factor VIIa (NovoSeven) in the treatment of internal bleeding in patients with factor VIII and IX inhibitors.

Recombinant factor VIIa (NovoSeven) was used on a compassionate use basis to treat 51 episodes of internal bleeding in 43 patients. All had become refractory to (or were not candidates for) other therapeutic agents. 26 of the 43 patients had hemophilia A and FVIII inhibitor antibodies, 13 had acquired FVIII inhibitors, 2 had hemophilia B and FIX inhibitors, and 2 had other coagulopathies, of 50 episodes of internal bleeding evaluated 76% had an excellent or effective response to rFVIIa. The average dosage given was 84 mu g/kg; the median number of doses given was 38. rFVIIa appears to be a very valuable addition to one's therapeutic armamentarium for treating serious bleeding episodes in inhibitor patients.