Haemostasis management
Treatment of haemophilia patients (both A and B) and patients with other coagulation factor deficiencies is normally based on replacement therapy (substitution of the missing clotting factor).
The replacement clotting factors are typically obtained from human plasma or, more recently, from recombinant (genetically engineered) preparations. Human plasma-derived clotting factors have the inherent risk of potentially transmitting certain viruses. However, antibodies or ‘inhibitors’ can develop following treatment with either human plasma factor concentrates or recombinant clotting factor preparations. The development of antibodies or inhibitors is very problematic as any injected replacement therapy will be ‘neutralised’ or made ineffective by the inhibitor. Since the late 1980's Novo Nordisk has been a pioneer in the development of a safe alternative to human plasma-based products. This pioneer work has led to the development of activated recombinant Factor VII (rFVIIa). This innovative treatment alternative has been shown to be highly effective in the treatment of haemophilia A or B patients that develop inhibitors to FVIII or FIX, respectively.
The other options that are available for treating haemophilia patients that develop inhibitors are high dose FVIII or FIX treatment (to overcome the inhibitor), porcine FVIII (FVIII derived from the plasma of pigs) or bypassing agents such as prothrombin complex concentrates (PCCs) or activated prothrombin complex concentrates (APCCs) which enhance the haemostatic process without the need of FVIII or FIX.
Novo Nordisk's commitment to the worldwide haemophilia community has made available an innovative and effective treatment for haemophilia patients with inhibitors. The potential use of rFVIIa in bleeding episodes unrelated to haemophilia is under investigation.
