Comparison of available BPAs for patients with hemophilia A and inhibitors
| . | rfVIIa . | aPCC . |
|---|---|---|
| Brand name | Novoseven RT | FEIBA VH |
| Product type | Recombinant | Plasma-derived, virally inactivated |
| Product contents | fVIIa | fII, fIX, fX, fVIIa |
| Half-life | 2-3 h | 8-12 h |
| Treatment dosing17 | 90-120 µg/kg every 2-3 h or 270 µg/kg × 1 | 50-100 IU/kg every 8-12 h (max dose, 200 IU/kg/day) |
| Prophylaxis dosing24,25 | 90 or 270 µg/kg daily | 85 IU/kg 3 times per week |
| Infusion volume* | 1 mg/mL (2 ml) | ∼40 IU/mL (40 mL) |
| Advantages | Lower infusion volumes | Less frequent dosing regimens |
| No risk for anamnesis | ||
| Disadvantages | Frequent dosing regimens | Large infusion volumes |
| Risk for anamnestic response | ||
| Contraindicated in patients with hemophilia B with inhibitors | ||
| General disadvantages of both agents | Requirement of reliable venous access | |
| Expensive and cost prohibited in some centers | ||
| Small theoretical risk for thrombosis | ||
| No reliable biomarkers available to correlate with therapeutic dosing or efficacy | ||
| Incomplete hemostatic effect compared with replacement factor in patients without inhibitors | ||
| . | rfVIIa . | aPCC . |
|---|---|---|
| Brand name | Novoseven RT | FEIBA VH |
| Product type | Recombinant | Plasma-derived, virally inactivated |
| Product contents | fVIIa | fII, fIX, fX, fVIIa |
| Half-life | 2-3 h | 8-12 h |
| Treatment dosing17 | 90-120 µg/kg every 2-3 h or 270 µg/kg × 1 | 50-100 IU/kg every 8-12 h (max dose, 200 IU/kg/day) |
| Prophylaxis dosing24,25 | 90 or 270 µg/kg daily | 85 IU/kg 3 times per week |
| Infusion volume* | 1 mg/mL (2 ml) | ∼40 IU/mL (40 mL) |
| Advantages | Lower infusion volumes | Less frequent dosing regimens |
| No risk for anamnesis | ||
| Disadvantages | Frequent dosing regimens | Large infusion volumes |
| Risk for anamnestic response | ||
| Contraindicated in patients with hemophilia B with inhibitors | ||
| General disadvantages of both agents | Requirement of reliable venous access | |
| Expensive and cost prohibited in some centers | ||
| Small theoretical risk for thrombosis | ||
| No reliable biomarkers available to correlate with therapeutic dosing or efficacy | ||
| Incomplete hemostatic effect compared with replacement factor in patients without inhibitors | ||
Infusion volume based on a 20-kg child with doses of rVIIa 2 mg and aPCC 1600 IU.