Experience with continuous infusion of recombinant activated factor VII inthe Asia-Pacific region

There is increasing interest in continuous infusion of recombinant activate d factor VII (rFVIIa) as a convenient and safe alternative to intermittent bolus therapy. In the Australian patients reported in this paper, cost savi ngs of up to 25% in the first 12 h of treatment with continuous infusion of rFVIIa have been achieved safely, suggesting that substantial overall savi ngs are possible. However, in the Thai patient reported, a dose reduction o f 35% in the first 12 h was associated with poor haemostatic control, sugge sting that a dose reduction of >25% may be inadvisable. The indications for treatment in the five Australian patients were: retroperitoneal haemorrhag e (n = 3); right forearm compartment syndrome (n = 1); wrist haemarthrosis and median nerve compression (n = 2); sublingual haematoma (n = 1); and cer ebral (mid-brain) haemorrhage (n = 1). Treatment was effective in four out of five patients (six bleeding episodes) and there was one treatment failur e where treatment had been substantially delayed. The Thai patient was trea ted as part of a prospective, uncontrolled, observational study of 34 bleed ing episodes in 22 patients in the Asia-Pacific region. Treatment was judge d ineffective after 24 h, but full haemostatic control was subsequently ach ieved with intermittent rFVIIa therapy. Blood Coagul Fibrinolysis 11 (suppl 1):S31-S34 (C) 2000 Lippincott Williams & Wilkins.