Recombinantfactor VIIa (eptacog alfa): nieuwe therapeutische optie bij patiënten met een ernstige bloeding door antistoffen tegen een stollingsfactor

In 2 patients with severe haemorrhage (a 63-year-old man with haemophilia A (the factor VIII level was 29) and a 44-year-old woman), of an inhibitory antibody against factor VIII was diagnosed. The development of recombinant factor VIIa (eptacog alpha) has made available a new therapeutic option for patients with an inhibitory antibody against a coagulation factor. Both patients were treated successfully with the new factor after other forms of treatment had failed. The new concept of the coagulation cascade on which the treatment with eptacog alpha is based assumes that the lack of an amplifying loop in the coagulation which takes place via factor IX (in combination with factor VIII) can be compensated by extra stimulation of the principal route (tissue factor-factor VIIa → factor X) by pharmacological amounts of factor VIIa.