Can activated recombinant factor VII be used to postpone the exposure of infants to factor VIII until after 2 years of age?
Two retrospective studies have suggested that exposure to factor VIII (FVIII) in early infancy is associated with an increased risk of FVIII inhibitor development. We prospectively studied 11 infants who needed replacement therapy for bleeding episodes before the age of 2 years. They received activa...
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| Veröffentlicht in: | Haemophilia : the official journal of the World Federation of Hemophilia 2005-07, Vol.11 (4), p.335-339 |
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| container_title | Haemophilia : the official journal of the World Federation of Hemophilia |
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| creator | Rivard, G. E. Lillicrap, D. Poon, M. C. Demers, C. Lépine, M. St-Louis, J. Warner, M. |
| description | Two retrospective studies have suggested that exposure to factor VIII (FVIII) in early infancy is associated with an increased risk of FVIII inhibitor development. We prospectively studied 11 infants who needed replacement therapy for bleeding episodes before the age of 2 years. They received activated recombinant factor VII (rFVIIa) concentrate on demand, with the intention of postponing their first exposure to FVIII after 2 years of age. Thirty‐three bleeding episodes were treated with 154 doses of rFVIIa with no evidence of adverse effect. Bleeding was controlled in 27 of 33 episodes. Mouth bleeds were most difficult to treat. The use of rFVIIa allowed postponement of the use of FVIII for a mean of 5.5 months (median 4, range 0–12) but in only three of 11 children could be the first exposure to factor postponed after the age of 2 years. With this modest effect of rFVIIa in postponing the first exposure to FVIII, more convincing evidence for the benefit of such a postponement will have to be demonstrated before rFVIIa could be recommended for this indication. |
| doi_str_mv | 10.1111/j.1365-2516.2005.01088.x |
| format | Article |
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E. ; Lillicrap, D. ; Poon, M. C. ; Demers, C. ; Lépine, M. ; St-Louis, J. ; Warner, M.</creator><creatorcontrib>Rivard, G. E. ; Lillicrap, D. ; Poon, M. C. ; Demers, C. ; Lépine, M. ; St-Louis, J. ; Warner, M.</creatorcontrib><description>Two retrospective studies have suggested that exposure to factor VIII (FVIII) in early infancy is associated with an increased risk of FVIII inhibitor development. We prospectively studied 11 infants who needed replacement therapy for bleeding episodes before the age of 2 years. They received activated recombinant factor VII (rFVIIa) concentrate on demand, with the intention of postponing their first exposure to FVIII after 2 years of age. Thirty‐three bleeding episodes were treated with 154 doses of rFVIIa with no evidence of adverse effect. Bleeding was controlled in 27 of 33 episodes. Mouth bleeds were most difficult to treat. The use of rFVIIa allowed postponement of the use of FVIII for a mean of 5.5 months (median 4, range 0–12) but in only three of 11 children could be the first exposure to factor postponed after the age of 2 years. 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E.</creatorcontrib><creatorcontrib>Lillicrap, D.</creatorcontrib><creatorcontrib>Poon, M. C.</creatorcontrib><creatorcontrib>Demers, C.</creatorcontrib><creatorcontrib>Lépine, M.</creatorcontrib><creatorcontrib>St-Louis, J.</creatorcontrib><creatorcontrib>Warner, M.</creatorcontrib><title>Can activated recombinant factor VII be used to postpone the exposure of infants to factor VIII until after 2 years of age?</title><title>Haemophilia : the official journal of the World Federation of Hemophilia</title><addtitle>Haemophilia</addtitle><description>Two retrospective studies have suggested that exposure to factor VIII (FVIII) in early infancy is associated with an increased risk of FVIII inhibitor development. We prospectively studied 11 infants who needed replacement therapy for bleeding episodes before the age of 2 years. They received activated recombinant factor VII (rFVIIa) concentrate on demand, with the intention of postponing their first exposure to FVIII after 2 years of age. Thirty‐three bleeding episodes were treated with 154 doses of rFVIIa with no evidence of adverse effect. Bleeding was controlled in 27 of 33 episodes. Mouth bleeds were most difficult to treat. The use of rFVIIa allowed postponement of the use of FVIII for a mean of 5.5 months (median 4, range 0–12) but in only three of 11 children could be the first exposure to factor postponed after the age of 2 years. With this modest effect of rFVIIa in postponing the first exposure to FVIII, more convincing evidence for the benefit of such a postponement will have to be demonstrated before rFVIIa could be recommended for this indication.</description><subject>Age Factors</subject><subject>Antifibrinolytic Agents - therapeutic use</subject><subject>Factor VII - therapeutic use</subject><subject>Factor VIIa</subject><subject>factor VIII</subject><subject>Factor VIII - antagonists & inhibitors</subject><subject>Factor VIII - therapeutic use</subject><subject>Genotype</subject><subject>Hemarthrosis - drug therapy</subject><subject>Hemophilia A - drug therapy</subject><subject>Hemophilia A - genetics</subject><subject>Hemorrhage - drug therapy</subject><subject>Humans</subject><subject>Infant</subject><subject>Mutation</subject><subject>Oral Hemorrhage - drug therapy</subject><subject>prevention of inhibitor exposure to factor VIII</subject><subject>Prospective Studies</subject><subject>Recombinant Proteins - therapeutic use</subject><subject>Treatment Outcome</subject><issn>1351-8216</issn><issn>1365-2516</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMtu1DAUhi0EoqXwCsgrdgm-xJcsEKpGZTpSVboAurQc5xgyZJLBdmBmgYTEm_IkOJ1Ru603Psfn-46lHyFMSUnzebsuKZeiYILKkhEiSkKJ1uXuCTq9Hzyda0ELzag8QS9iXBNCOSPyOTqhklAqdHWKfi_sgK1L3U-boMUB3LhpusEOCfv8PAb8ZbXCDeAp5nEa8XaMaTsOgNM3wLDL7RQAjx53g89WnJkHc4WnIXU9tj5BwOzfn797sCHOvP0K71-iZ972EV4d7zP0-cPFp8VlcfVxuVqcXxWuIkIXNYdaulYyqZx3vqk0UOEVUVBpVlGifO2Z9q5RvmnAtpyTmtFWaSm1bFTNz9Cbw95tGH9MEJPZdNFB39sBxikaqQnTlJEM6gPowhhjAG-2odvYsDeUmDl6szZzwmZO2MzRm7vozS6rr49_TM0G2gfxmHUG3h2AX10P-0cvNpfnF3OV_eLgdzHB7t634buRiithbq-Xhi_FLZU3xCz5f6jCohA</recordid><startdate>200507</startdate><enddate>200507</enddate><creator>Rivard, G. E.</creator><creator>Lillicrap, D.</creator><creator>Poon, M. C.</creator><creator>Demers, C.</creator><creator>Lépine, M.</creator><creator>St-Louis, J.</creator><creator>Warner, M.</creator><general>Blackwell Science Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200507</creationdate><title>Can activated recombinant factor VII be used to postpone the exposure of infants to factor VIII until after 2 years of age?</title><author>Rivard, G. E. ; Lillicrap, D. ; Poon, M. C. ; Demers, C. ; Lépine, M. ; St-Louis, J. ; Warner, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4058-93e96cd6267cfcfb48e15f707e4824107f9f28fcb7fbbead330921d786686b793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Age Factors</topic><topic>Antifibrinolytic Agents - therapeutic use</topic><topic>Factor VII - therapeutic use</topic><topic>Factor VIIa</topic><topic>factor VIII</topic><topic>Factor VIII - antagonists & inhibitors</topic><topic>Factor VIII - therapeutic use</topic><topic>Genotype</topic><topic>Hemarthrosis - drug therapy</topic><topic>Hemophilia A - drug therapy</topic><topic>Hemophilia A - genetics</topic><topic>Hemorrhage - drug therapy</topic><topic>Humans</topic><topic>Infant</topic><topic>Mutation</topic><topic>Oral Hemorrhage - drug therapy</topic><topic>prevention of inhibitor exposure to factor VIII</topic><topic>Prospective Studies</topic><topic>Recombinant Proteins - therapeutic use</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rivard, G. E.</creatorcontrib><creatorcontrib>Lillicrap, D.</creatorcontrib><creatorcontrib>Poon, M. C.</creatorcontrib><creatorcontrib>Demers, C.</creatorcontrib><creatorcontrib>Lépine, M.</creatorcontrib><creatorcontrib>St-Louis, J.</creatorcontrib><creatorcontrib>Warner, M.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Haemophilia : the official journal of the World Federation of Hemophilia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rivard, G. E.</au><au>Lillicrap, D.</au><au>Poon, M. 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They received activated recombinant factor VII (rFVIIa) concentrate on demand, with the intention of postponing their first exposure to FVIII after 2 years of age. Thirty‐three bleeding episodes were treated with 154 doses of rFVIIa with no evidence of adverse effect. Bleeding was controlled in 27 of 33 episodes. Mouth bleeds were most difficult to treat. The use of rFVIIa allowed postponement of the use of FVIII for a mean of 5.5 months (median 4, range 0–12) but in only three of 11 children could be the first exposure to factor postponed after the age of 2 years. With this modest effect of rFVIIa in postponing the first exposure to FVIII, more convincing evidence for the benefit of such a postponement will have to be demonstrated before rFVIIa could be recommended for this indication.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>16011584</pmid><doi>10.1111/j.1365-2516.2005.01088.x</doi><tpages>5</tpages></addata></record> |
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| subjects | Age Factors Antifibrinolytic Agents - therapeutic use Factor VII - therapeutic use Factor VIIa factor VIII Factor VIII - antagonists & inhibitors Factor VIII - therapeutic use Genotype Hemarthrosis - drug therapy Hemophilia A - drug therapy Hemophilia A - genetics Hemorrhage - drug therapy Humans Infant Mutation Oral Hemorrhage - drug therapy prevention of inhibitor exposure to factor VIII Prospective Studies Recombinant Proteins - therapeutic use Treatment Outcome |
| title | Can activated recombinant factor VII be used to postpone the exposure of infants to factor VIII until after 2 years of age? |
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