A Novel Approach to Treating FVIII Inhibitors: In Vitro Results for Combination Therapy with Human Prothrombin Complex Concentrate and Plasma-Derived FVIII/VWF Complex
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چکیده
Coagulation factor VIII (FVIII) inhibitors are the most severe complications of haemophilia A treatment. We studied the effect of a non-activated prothrombin concentrate (PCC) combined with FVIII in vitro. FVIII antibodies minimised the in vitro thrombin generation of standard human plasma and prolonged the lag phase at a residual FVIII activity of ≤ 0.01 IU/ml. Time to clotting of FVIII-inhibited fresh whole blood was not measurable until 55 minutes (observation time). Combining a PCC and a plasma-derived FVIII/VWF concentrate normalised TG and ROTEM® parameters. Our findings support an approach to moderately shift the haemostatic balance to a more procoagulant potential.
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