An in-vitro assessment of tranexamic acid as an adjunct to rFVIII or rFVIIa treatment in haemophilia A

摘要: Haemophilia is characterised by defective thrombin generation, reduced clot stability and spontaneous bleeding. Treatment with factor VIII (FVIII) concentrate or bypassing agents (e.g. recombinant VIIa (rFVIIa)) generally effective. Occasionally, haemostasis not achieved, which may reflect a failure of to normalise stability. Tranexamic acid (TXA) often used aid in surgery joint replacements dental procedures). Used routinely as an adjunct, it enhance allow effective, reliable, cost-effective treatment at lower doses concentrate. This study hypothesised that stabilising adjunct TXA required addition substitution whole blood from patients severe haemophilia A. The vitro effect varying concentrations FVIII FVIIa on was measured thromboelastometry. Coagulation triggered tissue clots were challenged plasminogen activator. area under the elasticity curve primary endpoint. High rFVIIa increased levels significantly different controls (Mean ± SD: control 112,694 84,115; 78,662 74,126; 95,918 88,492). However, response highly variable between individuals demonstrates why some show clinical resistance treatment. Addition resulted normalised all individuals, even when combined lowest results support concept more efficient, reliable cost effective be obtained if concentrates treat haemophilia.