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A comprehensive review of rFVIIa use in a tertiary care pediatric center
Author(s) -
Heller Mariel,
Lau Wendy,
PazminoCanizares Janneth,
Brandão Leonardo R.,
Carcao Manuel
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21375
Subject(s) - medicine , recombinant factor viia , blood product , pediatrics , surgery
Background Recombinant activated factor VII (rFVIIa) is a hemostatic agent developed for the treatment of bleeds in patients with hemophilia and inhibitors. Case reports/series document its growing use in patients without hemophilia. Such reports however do not accurately describe the proportion of rFVIIa used for various indications. We sought to document the complete use of rFVIIa at our institution over a 6‐year period (2000–2005). Procedure Using a computerized registry documenting all rFVIIa use in our institution a complete list of patients receiving rFVIIa was generated. Clinical data on these patients was obtained through chart review. Results 111 patients received 7,016,400 µg of rFVIIa over the 6 years: 23 patients had congenital bleeding disorders (10 patients with hemophilia and inhibitors; 7 with congenital FVII deficiency; 6 with platelet function disorders). These 23 patients (21% of all patients receiving rFVIIa) accounted for 79.9% of all rFVIIa used; patients with hemophilia alone accounted for 68.6%. The 88 patients without a congenital bleeding disorder (79% of all patients using rFVIIa) accounted for 20.1% of rFVIIa used. However their annual use of rFVIIa increased 10‐fold during the 6 years. Conclusions Patients with hemophilia use massive amounts of rFVIIa repeatedly while patients without hemophilia use rFVIIa infrequently and at smaller doses. The use of rFVIIa in patients without congenital bleeding disorders (all “off‐label” use) is rapidly growing in both number of patients and in total use and has likely significant clinical and economic ramifications. Pediatr Blood Cancer 2008;50:1013–1017. © 2007 Wiley‐Liss, Inc.