Case report on recombinant coagulation factor VIIa in the treatment of three haemophilia A patients with inhibitors in Singapore.

INTRODUCTION We report the first experiences with use of recombinant coagulation Factor VIIa (rFVIIa) in the treatment of haemophilia A patients with inhibitors in Singapore and discuss observations in 3 patients. CLINICAL PICTURE Case 1 bled on two separate occasions into his neck muscles and vocal cord. Case 2 had gross haematuria from bleeding in the renal calyxes. Case 3 bled into the parotid muscles. TREATMENT rFVIIa in doses, ranging from 50 ug/kg to 90 ug/kg, at different dosing intervals, were used. OUTCOME Excellent responses were seen in doses of 70 and 90 ug/kg. CONCLUSIONS rFVIIa is highly effective, both clinically and cost-wise, in the treatment of these patients.