Absence of thrombin generation during therapy with a highly purified solvent/detergent treated factor IX concentrate

Traditional factor IX concentrate preparations contain a variety of procoagulants and their use is associated with thromboembolic complications and disseminated intravascular coagulation. A highly purified factor IX concentrate (AlphaNine) has been developed but it has been shown to have the potential for transmitting non A, non B hepatitis. More recently, an alternative highly purified factor IX concentrate (FIX SDHP) with improved viral inactivation has been developed. We evaluated this preparation in a patient with hemophilia B who underwent knee surgery. In this prothrombotic setting, repeated injections of large doses of FIX SDHP did not activate the coagulation system, suggesting that FIX SDHP may be a potentially safe and efficacious therapy for hemophilia B.