Blood Transfusion Supplement 4 - Plasma-derived medicinal products: demand and clinical use (off subscription) (September)
Clinical use and the Italian demand for activated prothrombin complex and activated recombinant factor VII concentrates
 
Authors:  Antonio Coppola, Annarita Tagliaferri, Gabriele Calizzani, Fabio Candura, Massimo Franchini, Carlo Ruosi, Giuliano Grazzini, Giovanni Di Minno
Pages:  101-109
To cite this article:  Blood Transfus 2013; 11 Suppl 4: s101-9
Doi:  10.2450/2013.016s
Published online:  08/10/2013

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Introduction
The activated prothrombin complex concentrate (aPCC, Factor Eight Inhibitor Bypassing Activity, FEIBA, Baxter, Deerfield, IL, USA) and the recombinant activated factor VII concentrate (rFVIIa, NovoSeven, Novo Nordisk A/S, Bagsværd, Denmark) are the socalled "by-passing agents", i.e. products able to promote haemostasis through mechanisms alternative to the physiological tenase complex, in which a phospholipiddependent reaction occurs with factor (F) X as the substrate, activated (a) FIX as the enzyme and FVIIIa as a cofactor1. The mechanism(s) of action of these agents are still not completely elucidated. The aPCC, which contains activated FII, FIX, FX and small amounts of FVII, is thought to facilitate thrombin generation on the platelet surface. This product was first introduced in clinical practice in 1975, as a therapeutic agent for haemophilia B when specific FIX concentrates were not available, and in the current vapour-heated formulation in 19852. (...)
  
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