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 µg/kg to 90 µg/kg, at different dosing intervals, were used. Outcome: Excellent responses were seen in doses of 70 and 90 µg/kg. Conclusion: rFVIIa is highly effective, both clinically and cost-wise, in the treatment of these patients.
Development of inhibitors against factor VIII is one of the main complications in the treatment of haemophiliacs. Inhibitors block the procoagulant effects of factor VIII and prevent the successful arrest of bleeding episodes when administered to these haemophiliacs.
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