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Differential response to bypassing agents complicates treatment in patients with haemophilia and inhibitors
Author(s) -
BERNTORP E.
Publication year - 2009
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/j.1365-2516.2008.01931.x
Subject(s) - medicine , haemophilia , haemophilia a , intensive care medicine , differential effects , pharmacology , bioinformatics , surgery , biology
Summary. The bypassing agents factor eight inhibitor bypassing activity (FEIBA) anti‐inhibitor coagulant complex and recombinant activated factor VII (rFVIIa) have been established as safe and effective therapies for treating bleeding episodes in haemophilia patients with inhibitors. However, the efficacy of each bypassing agent can vary, and neither agent is universally effective. The reasons for such variability have yet to be confirmed, but may involve patient‐specific factors and the mechanisms of action (MOAs) and pharmacokinetic profiles of these two agents. This issue underscores the necessity of both products in the comprehensive care of patients with haemophilia and inhibitors. The objective of this review is to discuss the evidence of a differential haemostatic response to bypassing agents and the potential roles of MOA and patient‐specific factors in contributing to the differences in response.