Monitoring bypassing agent therapy – a prospective crossover study comparing thromboelastometry and thrombin generation assay

摘要: The aim of this study was to evaluate the capability thromboelastometry (ROTEM) and thrombin generation assay (TGA) monitor treatment response bypassing agent (BPA) therapy whether one method is superior another. In a prospective crossover haemophilia A patients with high titre inhibitors were included receive dose 75 U kg(-1) activated prothrombin complex concentrates (aPCC) intravenously. Blood sampling performed at baseline, 15, 30 min, 1, 2, 3 4 h post-infusion for TGA ROTEM analysis. After washout period 14 days subjects received recombinant FVIIa (rFVIIa) 90 μg similar blood performed. Healthy used as controls. Six included. We found that parameters endogenous potential (ETP) peak increased 2-3 folds from baseline 15-30 min after infusion. MaxVel maximum clot firmness level comparable healthy An individual difference in observed different among participants. ETP almost two-fold greater following aPCC infusion compared rFVIIa, whereas showed no between two products. have great effect BPA inhibitors. seemed be more sensitive than reflecting rFVIIa. Additional clinical studies are needed clarify which what clinically predictive.