Rationale for the Potential Use of Recombinant Activated Factor VII in Severe Post-Partum Hemorrhage

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F24%3A00079886" target="_blank" >RIV/65269705:_____/24:00079886 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/24:00136869

Result on the web

<a href="https://www.mdpi.com/2077-0383/13/10/2928" target="_blank" >https://www.mdpi.com/2077-0383/13/10/2928</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3390/jcm13102928" target="_blank" >10.3390/jcm13102928</a>

Result language

angličtina

Original language name

Rationale for the Potential Use of Recombinant Activated Factor VII in Severe Post-Partum Hemorrhage

Original language description

Severe post-partum hemorrhage (PPH) is a major cause of maternal mortality worldwide. Recombinant activated factor VII (rFVIIa) has recently been approved by the European Medicines Agency for the treatment of severe PPH if uterotonics fail to achieve hemostasis. Although large randomized controlled trials are lacking, accumulated evidence from smaller studies and international registries supports the efficacy of rFVIIa alongside extended standard treatment to control severe PPH. Because rFVIIa neither substitutes the activity of a missing coagulation factor nor bypasses a coagulation defect in this population, it is not immediately evident how it exerts its beneficial effect. Here, we discuss possible mechanistic explanations for the efficacy of rFVIIa and the published evidence in patients with severe PPH. Recombinant FVIIa may not primarily increase systemic thrombin generation, but may promote local thrombin generation through binding to activated platelets at the site of vascular wall injury. This explanation may also address safety concerns that have been raised over the administration of a procoagulant molecule in a background of increased thromboembolic risk due to both pregnancy-related hemostatic changes and the hemorrhagic state. However, the available safety data for this and other indications are reassuring and the rates of thromboembolic events do not appear to be increased in women with severe PPH treated with rFVIIa. We recommend that the administration of rFVIIa be considered before dilutional coagulopathy develops and used to support the current standard treatment in certain patients with severe PPH.

Czech name

—

Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30218 - General and internal medicine

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of Clinical Medicine

ISSN

2077-0383

e-ISSN

2077-0383

Volume of the periodical

13

Issue of the periodical within the volume

10

Country of publishing house

CH - SWITZERLAND

Number of pages

8

Pages from-to

2928

UT code for WoS article

001234852000001

EID of the result in the Scopus database

2-s2.0-85194394673