A recently published research paper suggests that a treatment regimen that includes both plasma-derived, activated prothrombin complex concentrates (aPCCs) and recombinant activated factor VII (rFVIIa) could potentially control bleeding in hemophilia patients who normally do not respond to either of the drugs alone. Geoffrey Allen, MD, is lead author of the study. He is the director of the Comprehensive Hemophilia & Thrombosis Program at Children’s Memorial Hospital in Chicago.

Using a cell-based model of hemophilia, researchers observed significant increases in production of the coagulation protein thrombin following combinations of aPCCs with rFVIIa.

“At all concentrations of rFVIIa, increased prothrombin concentrations led to increases in the peak and rate of thrombin generation,” reported the study authors. Thrombin generation is used as a key predictor of the potential for effective hemostasis (the arrest of bleeding) because the protein plays several crucial roles in the clotting process.

Among the conclusions of Dr. Allen and his colleagues were that coordinated therapy of aPCCs/rFVIIa may become a viable treatment option with improved clinical outcomes. “These results suggest that increasing plasma prothrombin concentration prior to rFVIIa administration may offer advantages over the use of rFVIIa alone in the treatment of haemophilic bleeding,” he said.

The results of the study, “Manipulation of Prothrombin Concentration Improves Response to High-Dose Factor VIIa in a Cell-based Model of Haemophilia,” were published in the August 2006 issue of the British Journal of Haematology.

Source: Hematology Week, August 28, 2006