Parallel use of by-passing agents in haemophilia with inhibitors: a critical review.

摘要: In the absence of new outbreaks transfusion-related infections, occurrence neutralizing antibodies currently remains most prominent complication in haemophilia. Coagulation factor products that may circumvent inadequate activation X classical haemophilia, often referred to as bypassing agents, have demonstrated a high degree efficacy. A smaller number patients been described whom either agent, or both, demonstrate diminished those cases, use both agents parallel was attempted, using simultaneous (combined) alternating (sequential) infusion two drugs, reportedly with successful haemostasis. We speculated whether such treatment might cause thromboembolism. thorough literature search disclosed 17 reports regarding same bleeding episode 49 patients; reporting nine acquired haemophilia and forty congenital inhibitors. Notable incidences thromboembolic manifestations were observed: five 40 suffered from significant thrombotic complications, overall four cases fatal. Although efficacy reported excellent thromboembolism is rare activated prothrombin complex concentrate recombinant human VII appears increase risk thrombosis these patients.