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A retrospective study of Octaplex in the treatment of bleeding in patients with haemophilia A complicated by inhibitors.

Berntorp, Erik LU ; Figueiredo, Sandra; Futema, Lucimara; Pock, Katharina; Knaub, Sigurd; Walter, Olaf; Trawnicek, Laurenz and Römisch, Jürgen (2010) In Blood Coagulation and Fibrinolysis 21. p.577-583
Abstract
The nonactivated prothrombin complex concentrate (PCC) Octaplex (Octapharma PPGmbH, Vienna, Austria) has been used successfully for the treatment of congenital and acquired coagulation factor deficiencies and associated bleeding. The aims of this study were to assess retrospectively whether Octaplex is an effective treatment option for haemophilia A patients with high-titre inhibitors of factor VIII (FVIII) and to investigate the impact of Octaplex on thrombin generation in vitro and ex vivo. Retrospective data were collected from 15 haemophilia A patients with FVIII inhibitors who had been treated with Octaplex. Mild bleeds were treated for a median of 1 day with a median dose of 77 IU/kg and moderate bleeds for 3 days with 57 IU/kg. The... (More)
The nonactivated prothrombin complex concentrate (PCC) Octaplex (Octapharma PPGmbH, Vienna, Austria) has been used successfully for the treatment of congenital and acquired coagulation factor deficiencies and associated bleeding. The aims of this study were to assess retrospectively whether Octaplex is an effective treatment option for haemophilia A patients with high-titre inhibitors of factor VIII (FVIII) and to investigate the impact of Octaplex on thrombin generation in vitro and ex vivo. Retrospective data were collected from 15 haemophilia A patients with FVIII inhibitors who had been treated with Octaplex. Mild bleeds were treated for a median of 1 day with a median dose of 77 IU/kg and moderate bleeds for 3 days with 57 IU/kg. The physician's overall satisfaction with Octaplex, taking into account efficacy, safety and cost in comparison with other treatment options, was assessed for each bleed. The overall rating was good, very good or excellent for 29 of 41 (71%) bleeds. No adverse drug reactions were reported. In in-vitro studies of thrombin generation with normal plasma samples, experimental inhibition of FVIII activity prolonged the lag phase, diminished the peak thrombin concentration and decreased the area under the concentration-time curve, as expected. Marked improvement in thrombin generation parameters was achieved by adding 0.5-3 IU factor IX/ml PCC into the samples. The same held true when using plasma samples from haemophilia A patients with FVIII inhibitors. These results demonstrate that Octaplex overcomes inhibition of FVIII in in-vitro and ex-vivo assays of thrombin generation, and that Octaplex is an effective treatment option for haemophilia A patients with FVIII inhibitors. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
Blood Coagulation and Fibrinolysis
volume
21
pages
577 - 583
publisher
Lippincott Williams and Wilkins
external identifiers
  • wos:000281115200012
  • pmid:20644466
  • scopus:77955918129
ISSN
1473-5733
DOI
10.1097/MBC.0b013e32833c9ab9
language
English
LU publication?
yes
id
19aabc30-bc7c-4935-8082-7d7020ef7825 (old id 1644755)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20644466?dopt=Abstract
date added to LUP
2010-08-03 10:10:00
date last changed
2018-11-21 20:50:08
@article{19aabc30-bc7c-4935-8082-7d7020ef7825,
  abstract     = {The nonactivated prothrombin complex concentrate (PCC) Octaplex (Octapharma PPGmbH, Vienna, Austria) has been used successfully for the treatment of congenital and acquired coagulation factor deficiencies and associated bleeding. The aims of this study were to assess retrospectively whether Octaplex is an effective treatment option for haemophilia A patients with high-titre inhibitors of factor VIII (FVIII) and to investigate the impact of Octaplex on thrombin generation in vitro and ex vivo. Retrospective data were collected from 15 haemophilia A patients with FVIII inhibitors who had been treated with Octaplex. Mild bleeds were treated for a median of 1 day with a median dose of 77 IU/kg and moderate bleeds for 3 days with 57 IU/kg. The physician's overall satisfaction with Octaplex, taking into account efficacy, safety and cost in comparison with other treatment options, was assessed for each bleed. The overall rating was good, very good or excellent for 29 of 41 (71%) bleeds. No adverse drug reactions were reported. In in-vitro studies of thrombin generation with normal plasma samples, experimental inhibition of FVIII activity prolonged the lag phase, diminished the peak thrombin concentration and decreased the area under the concentration-time curve, as expected. Marked improvement in thrombin generation parameters was achieved by adding 0.5-3 IU factor IX/ml PCC into the samples. The same held true when using plasma samples from haemophilia A patients with FVIII inhibitors. These results demonstrate that Octaplex overcomes inhibition of FVIII in in-vitro and ex-vivo assays of thrombin generation, and that Octaplex is an effective treatment option for haemophilia A patients with FVIII inhibitors.},
  author       = {Berntorp, Erik and Figueiredo, Sandra and Futema, Lucimara and Pock, Katharina and Knaub, Sigurd and Walter, Olaf and Trawnicek, Laurenz and Römisch, Jürgen},
  issn         = {1473-5733},
  language     = {eng},
  pages        = {577--583},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Blood Coagulation and Fibrinolysis},
  title        = {A retrospective study of Octaplex in the treatment of bleeding in patients with haemophilia A complicated by inhibitors.},
  url          = {http://dx.doi.org/10.1097/MBC.0b013e32833c9ab9},
  volume       = {21},
  year         = {2010},
}