Recombinant Activated Factor VII: The Delicate Balance between Efficacy and Safety
Endogenous activated factor VII (FVIIa) plays a crucial role in the effective coagulation process. The clotting drug NovoSeven® (Novo Nordisk A/S, Bagsvaerd, Denmark) is structurally nearly identical to endogenous FVIIa and is produced by recombination from a baby hamster kidney cell line. Supra-physiologic concentrations of FVIIa are achieved by the administration of pharmacological doses of recombinant FVIIa (rFVIIa). To generate thrombin, rFVIIa needs either tissue factor or activated platelets (tissue factor-independent generation). Consequently, rFVIIa is approved for the prevention and the treatment of bleeding in patients with a range of congenital hemostatic disorders, mainly hemophilia. Its high efficacy in various hemostatic defects has oriented its application to the perioperative setting, trauma, and ICU patients. Over the last five years, the estimated number of patients treated with rVIIa has grown rapidly, mainly for off-license indications.
KeywordsThromboembolic Complication Dengue Hemorrhagic Fever Spontaneous Intracerebral Hemorrhage Blood Coagul Fibrinolysis Human Coagulation Factor
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