The pharmacokinetics of clotting factor therapy

被引:47
作者
Berntorp, E
Björkman, S
机构
[1] Malmo Univ Hosp, Dept Coagulat Disorders, SE-20502 Malmo, Sweden
[2] Malmo Univ Hosp, Hosp Pharm, SE-20502 Malmo, Sweden
关键词
factor VIIa; factor VIII; factor IX; haemophilia A; haemophilia B; pharmacokinetics; RECOMBINANT FACTOR-VIII; MODEL-INDEPENDENT METHODS; ACTIVATED FACTOR-VII; FACTOR-IX; HEMOPHILIA-A; PROPHYLACTIC TREATMENT; CONTINUOUS-INFUSION; COAGULATION-FACTORS; HOME TREATMENT; HALF-LIFE;
D O I
10.1046/j.1365-2516.2003.00762.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Clotting factor preparations are expensive and not readily available in all parts of the world. We are still facing shortages due to limited production. Thus, it is obvious that clotting factor therapy should be optimised as far as possible. The judicious use of pharmacokinetic principles should be one of the fundaments of dosing. There are several pitfalls in studies of clotting factor pharmacokinetics, such as discrepancies between assays, inadequate blood sampling protocols, problems to define the administered dose, uncertainty in the estimation of plasma volume for in vivo recovery calculation, and post-infusion activation of the clotting factor. Thus, while the pharmacokinetics of factor VIII is well characterised there are some discrepancies in the literature on factor IX. Recombinant factor VIIa is useful to treat haemorrhages in haemophilia complicated by inhibitors. The pharmacokinetics of VIIa has been investigated, however, the relationship between plasma level of VIIa and effect needs further exploration. Important applications of clotting factor pharmacokinetics include optimising the treatment and improving its cost-effectiveness during long-term prophylaxis as well as during bleeding episodes and surgery.
引用
收藏
页码:353 / 359
页数:7
相关论文
共 47 条
[1]  
ALLAIN JP, 1984, SCAND J HAEMATOL, V33, P123
[2]   INVITRO AND INVIVO CHARACTERIZATION OF FACTOR-VIII PREPARATIONS [J].
ALLAIN, JP ;
VERROUST, F ;
SOULIER, JP .
VOX SANGUINIS, 1980, 38 (02) :68-80
[3]  
BARROWCLIFFE TW, 1993, THROMB HAEMOSTASIS, V70, P876
[4]  
BERNTORP E, 1997, HEMOPHILIA, P181
[5]   The pharmacokinetics of factor VIII and factor IX: Methodology, pitfalls and applications [J].
Bjorkman, S ;
Carlsson, M .
HAEMOPHILIA, 1997, 3 (01) :1-8
[6]   Pharmacokinetics of recombinant factor IX in relation to age of the patient:: implications for dosing in prophylaxis [J].
Björkman, S ;
Shapiro, AD ;
Berntorp, E .
HAEMOPHILIA, 2001, 7 (02) :133-139
[7]  
Björkman S, 2001, CLIN PHARMACOKINET, V40, P815
[8]  
BJORKMAN S, 1992, CLIN PHARMACOKINET, V22, P385
[9]  
BJORKMAN S, 1994, EUR J CLIN PHARMACOL, V46, P325
[10]   Improved cost-effectiveness by pharmacokinetic dosing of factor VIII in prophylactic treatment of haemophilia A [J].
Carlsson, M ;
Berntorp, E ;
Bjorkman, S ;
Lethagen, S ;
Ljung, R .
HAEMOPHILIA, 1997, 3 (02) :96-101