Continuous Infusion of Recombinant Factor VIIa in Hemophilic Patients with Inhibitors: Safety, Monitoring, and Cost Effectiveness

The continuous infusion of recombinant activated factor VII (rFVIIa) was first described in 1996. Because of the significant benefits in convenience and cost that can be achieved with this mode of administration compared with bolus doses, the method was quickly adopted, albeit with many local variations. Some of those have been less favorable, resulting in hemorrhagic complications. The potential pitfalls and experiences from a large number of cases collected in an international registry of continuous infusion with rFVIIa are reviewed. The only indications discussed here are hemophilia A or B with inhibitors or acquired hemophilia. Different recommendations may apply for other indications.