FEIBA: A Prohemostatic Agent

Abstract

Factor eight inhibitor bypassing activity (FEIBA), Anti-Inhibitor Coagulation Complex has been used for over 30 years in hemophiliac patients with inhibitors. The history of its use is reviewed here, including issues related to thrombosis, efficacy, and comparison to alternative bypassing agents. The need for surrogate assays to monitor effective hemostasis with the use of FEIBA remains.

Keywords

inhibitors - hemophilia - factor eight inhibitor bypassing activity - thrombosis

• References

• 1 Darby SC, Keeling DM, Spooner RJ , et al; UK Haemophilia Centre Doctors' Organisation. The incidence of factor VIII and factor IX inhibitors in the hemophilia population of the UK and their effect on subsequent mortality, 1977–99. J Thromb Haemost 2004; 2 (7) 1047-1054
• 2 Berntorp E, Shapiro A, Astermark J , et al. Inhibitor treatment in haemophilias A and B: summary statement for the 2006 international consensus conference. Haemophilia 2006; 12 (Suppl. 06) 1-7
• 3 Kurczynski EM, Penner JA. Activated prothrombin concentrate for patients with factor VIII inhibitors. N Engl J Med 1974; 291 (4) 164-167
• 4 Green D. Complications associated with the treatment of haemophiliacs with inhibitors. Haemophilia 1999; 5 (Suppl. 03) 11-17
• 5 Leissinger CA, Blatt PM, Hoots WK, Ewenstein B. Role of prothrombin complex concentrates in reversing warfarin anticoagulation: a review of the literature. Am J Hematol 2008; 83 (2) 137-143
• 6 Hilgartner MW, Knatterud GL. The use of factor eight inhibitor by-passing activity (FEIBA immuno) product for treatment of bleeding episodes in hemophiliacs with inhibitors. Blood 1983; 61 (1) 36-40
• 7 Negrier C, Goudemand J, Sultan Y, Bertrand M, Rothschild C, Lauroua P. Multicenter retrospective study on the utilization of FEIBA in France in patients with factor VIII and factor IX inhibitors. French FEIBA Study Group. Factor Eight Bypassing Activity. Thromb Haemost 1997; 77 (6) 1113-1119
• 8 Dimichele D, Négrier C. A retrospective postlicensure survey of FEIBA efficacy and safety. Haemophilia 2006; 12 (4) 352-362
• 9 Berntorp E. Differential response to bypassing agents complicates treatment in patients with haemophilia and inhibitors. Haemophilia 2009; 15 (1) 3-10
• 10 Dargaud Y, Lienhart A, Meunier S , et al. Major surgery in a severe haemophilia A patient with high titre inhibitor: use of the thrombin generation test in the therapeutic decision. Haemophilia 2005; 11 (5) 552-558
• 11 Dargaud Y, Lienhart A, Negrier C. Prospective assessment of thrombin generation test for dose monitoring of bypassing therapy in hemophilia patients with inhibitors undergoing elective surgery. Blood 2010; 116 (25) 5734-5737
• 12 Klintman J, Astermark J, Berntorp E. Combination of FVIII and by-passing agent potentiates in vitro thrombin production in haemophilia A inhibitor plasma. Br J Haematol 2010; 151 (4) 381-386
• 13 Turecek PL, Váradi K, Keil B , et al. Factor VIII inhibitor-bypassing agents act by inducing thrombin generation and can be monitored by a thrombin generation assay. Pathophysiol Haemost Thromb 2003; 33 (1) 16-22
• 14 Chavin SI, Siegel DM, Rocco Jr TA, Olson JP. Acute myocardial infarction during treatment with an activated prothrombin complex concentrate in a patient with factor VIII deficiency and a factor VIII inhibitor. Am J Med 1988; 85 (2) 245-249
• 15 Fukui H, Fujimura Y, Takahashi Y, Mikami S, Yoshioka A. Laboratory evidence of DIC under FEIBA treatment of a hemophilic patient with intracranial bleeding and high titre factor VIII inhibitor. Thromb Res 1981; 22 (1–2) 177-184
• 16 Schimpf K, Zeltsch C, Zeltsch P. Myocardial infarction complicating activated prothrombin complex concentrate substitution in patient with hemophilia A. Lancet 1982; 2 (8306) 1043
• 17 Cederbaum AI, Blatt PM, Roberts HR. Intravascular coagulation with use of human prothrombin complex concentrates. Ann Intern Med 1976; 84 (6) 683-687
• 18 Lusher JM. Thrombogenicity associated with factor IX complex concentrates. Semin Hematol 1991; 28 (3, Suppl 6) 3-5
• 19 Ehrlich HJ, Henzl MJ, Gomperts ED. Safety of factor VIII inhibitor bypass activity (FEIBA): 10-year compilation of thrombotic adverse events. Haemophilia 2002; 8 (2) 83-90
• 20 Leissinger C, Gringeri A, Antmen B , et al. Anti-inhibitor coagulant complex prophylaxis in hemophilia with inhibitors. N Engl J Med 2011; 365 (18) 1684-1692
• 21 Turecek PL, Váradi K, Gritsch H, Schwarz HP. FEIBA: mode of action. Haemophilia 2004; 10 (Suppl. 02) 3-9
• 22 Aledort LM. MedWatch: an important instrument for postlicensing surveillance. J Thromb Haemost 2006; 4 (7) 1637
• 23 Astermark J, Donfield SM, DiMichele DM , et al; FENOC Study Group. A randomized comparison of bypassing agents in hemophilia complicated by an inhibitor: the FEIBA NovoSeven Comparative (FENOC) Study. Blood 2007; 109 (2) 546-551
• 24 Ingerslev J, Sørensen B. Parallel use of by-passing agents in haemophilia with inhibitors: a critical review. Br J Haematol 2011; 155 (2) 256-262