Experiences with recombinant FVIIa in the emergency treatment of patients with autoimmune thrombocytopenia: a review of the literature

Patients with severe and refractory autoimmune thrombocytopenia (ITP) have significant morbidity and mortality rates. Currently, high-dose methylprednisolone and/or high-dose IVIgG are recommended for the emergency treatment of such patients with uncontrolled bleeding. However, some patients do not immediately respond to these therapeutic regimes and may require additional treatment. Recombinant activated FVIIa (rFVIIa) is a prothrombotic agent that appears to be useful in the treatment of patients with life-threatening bleeding. It has also been used in the treatment of several patients with thrombocytopenia. We administered rFVIIa into a patient with refractory ITP and performed a systemic review of all published reports to assess the available evidence on the efficacy and safety of this drug in patients with ITP. The results indicate that rFVIIa may help in the emergency treatment of patients with ITP who do not respond to other therapies.