Novel applications of recombinant factor VIIa for the management of pediatric coagulopathic diseases

Recombinant factor VIIa (rFVIIa) was envisioned for the treatment of bleeding in hemophilia patients with inhibitors. In response to tissue factor expressed upon vessel wall injury, rFVIIa amplifies the thrombin burst primarily on membrane surfaces, including activated platelets. Because it is functional at a key point in the clotting cascade, rFVIIa shows promise as a therapeutic option for various bleeding situations. The prothrombin time (PT) is often used as a surrogate to monitor rFVIIa therapy. Using laboratory and clinical measures of outcome, the use of rVIIa as a therapeutic option in treating several different pediatric coagulopathic conditions is described.