Continuous Infusion of Factor Concentrates: Review of Use in Hemophilia A and Demonstration of Safety and Efficacy in Hemophilia B

Continuous infusions of factor VIII have proved feasible in patients with hemophilia A, and the hemostatic efficacy has sometimes been superior to that of repeated bolus injections of factor VIII. Avoiding dangerously low trough levels by maintaining a constant therapeutic level not only promotes hemostasis but requires substantially less factor concentrate, which represents a considerable saving. Only limited data on continuous infusion of factor IX are available, but these data suggest similar benefits. An investigation of the stability of four prothrombin complex concentrates and three highly purified factor IX concentrates is described, as is the successful treatment of four hemophilia B patients with continuous infusions of Mononine.