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Recombinant FVIIa in elective non-orthopaedic surgery of adults with haemophilia and inhibitors: A systematic literature review
- Source :
- Haemophilia, Vol. 27, no. 3, p. e314-e330 (2021)
- Publication Year :
- 2021
-
Abstract
- Aim: To assess available evidence on the use of rFVIIa in non-orthopaedic surgery including dental surgery in adult patients with congenital haemophilia with inhibitors (PWHI). Methods: A systematic literature search was performed according to a prespecified search string; prespecified criteria were used to select applicable studies including PWHI ≥18 years of age who underwent any non-orthopaedic surgery using rFVIIa. Results: Thirty-three publications met the eligibility criteria, of which 26 publications – including 46 procedures in 44 patients – were selected for the qualitative analysis. Most publications were case reports or case series (21/26). Primary authors assessed rFVIIa as effective in maintaining haemostasis during and after most major surgeries (22/32). rFVIIa dose was mainly on label, with higher doses used in 4 cases, and a lower dose in 1 case. Duration of treatment was mostly 5–10 days (range: 3 days to 1 month post-operatively). Adverse events related to rFVIIa were rare. Conclusions: Assessing non-orthopaedic surgery in this patient population is hampered by a paucity of published data; nevertheless, the current evidence indicates that rFVIIa is effective in achieving haemostasis in haemophilia patients with inhibitors undergoing elective non-orthopaedic or dental surgery. rFVIIa was generally well tolerated in these patients, with thrombotic events occurring rarely. These data, generated to help clinicians manage congenital haemophilia with inhibitors, highlight the need for more systematic reporting of rFVIIa and all other therapeutic agents in non-orthopaedic surgery and dental surgery in patients with congenital haemophilia and inhibitors. (Less)
- Subjects :
- Adult
Haemophilia
medicine.medical_specialty
Pediatrics
Inhibitor
Factor VIIa
030204 cardiovascular system & hematology
Hemophilia A
03 medical and health sciences
Oral surgery
0302 clinical medicine
Qualitative analysis
medicine
Humans
In patient
Adverse effect
Genetics (clinical)
biology
business.industry
rFVIIa
Hematology
General Medicine
medicine.disease
Recombinant Proteins
Major surgery
Systematic review
Recombinant factor VIIa
Elective Surgical Procedures
Dental surgery
Orthopedic surgery
biology.protein
business
030215 immunology
Subjects
Details
- ISSN :
- 13652516
- Volume :
- 27
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Haemophilia : the official journal of the World Federation of HemophiliaREFERENCES
- Accession number :
- edsair.doi.dedup.....6a273a2ccca6291531d0bdeaf2ac76ca