Activated Recombinant Factor Viia

Preliminary studies suggest that activated recombinant factor VII (rFVIIa) is capable of promoting hemostasis at sites of vascular injury, thus minimizing hematoma growth after ICH. The overall frequency of ICH growth in a study of 48 patients (defined as larger than 33%, or more than 12.5 cc from the original hematoma volume) was 20% at 24 hours. following the administration of rFVIIa (15). These results compare favorably with the 38% hematoma enlargement reported previously (9). Subsequently a large, multicentered trial of similar design comparing 40-, 80-, and 160-^g/kg rFVIIa and placebo was undertaken in nearly 400 patients to determine the ability of this treatment to effectively limit ICH growth (16). This study demonstrated a statistically significant decrease in hematoma growth in the group treated with rFVIIa compared with the placebo group. A significant reduction in mortality (18-29%) and poor outcomes was also reported. Notably, serious thromboembolic adverse events (myocardial or cerebral infarction) occurred in 7% of rFVIIa-treated patients, as compared with 2% of those given placebo. Thus, the recommended dose of this drug in the acute treatment of ICH remains unclear at this time.




2-10 |jg kg-1 min-1 2-20 |g kg-1 min-1 Titrate from 0.05-0.2 |g kg-1 min

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