J 2024

Efficacy and Safety Analyses of Recombinant Factor VIIa in Severe Post-Partum Hemorrhage

CARAM-DEELDER, Camila, McKinnon Edwards HELLEN, Jarmila A ZDANOWICZ, van den Akker THOMAS, Camilla BIRKEGARD et. al.

Základní údaje

Originální název

Efficacy and Safety Analyses of Recombinant Factor VIIa in Severe Post-Partum Hemorrhage

Autoři

CARAM-DEELDER, Camila, McKinnon Edwards HELLEN, Jarmila A ZDANOWICZ, van den Akker THOMAS, Camilla BIRKEGARD, Jan BLATNÝ (203 Česká republika, domácí), Johanna G VAN DER BOM, Giuseppe COLUCCI, Derek VAN DUUREN, Nan VAN GELOVEN, Dacia D C A HENRIQUEZ, Marian KNIGHT, Lars KORSHOLM, Andrea LANDORPH, Lavigne Lissalde GERALDINE, Zoe K MCQUILTEN, Daniel SURBEK, Cameron WELLARD, Erica M WOOD a Frederic J MERCIER

Vydání

Journal of Clinical Medicine, Basel, MDPI, 2024, 2077-0383

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30204 Oncology

Stát vydavatele

Švýcarsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 3.900 v roce 2022

Organizační jednotka

Lékařská fakulta

UT WoS

001219832000001

Klíčová slova anglicky

recombinant activated factor VII; post-partum hemorrhage; pregnancy complications; hematologic; coagulants; therapeutic use; thromboembolic events; delivery; obstetric; maternal mortality

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 20. 8. 2024 12:31, Mgr. Tereza Miškechová

Anotace

V originále

Background: Despite a range of available treatments, it is still sometimes challenging to treat patients with severe post-partum hemorrhage (sPPH). Objective: This study evaluated the efficacy and safety of recombinant activated factor VIIa (rFVIIa) in sPPH management. Methods: An open-label, multi-center, randomized controlled trial (RCT; NCT00370877) and four observational studies (OS; OS-1 (NCT04723979), OS-2, OS-3, and OS-4) were analyzed regarding efficacy (need for subsequent invasive procedures, including uterine compression sutures, uterine or iliac artery ligations, arterial embolization, or hysterectomy) and safety (incidence of thromboembolic events (TE) and maternal mortality) of rFVIIa for sPPH. The RCT, and OS-1 and OS-2, included a control group of women who did not receive rFVIIa (with propensity score-matching used in OS-1 and OS-2), whereas OS-3 and OS-4 provided descriptive data for rFVIIa-exposed women only. Results: A total of 446 women exposed to rFVIIa and 1717 non-exposed controls were included. In the RCT, fewer rFVIIa-exposed women (50% [21/42]) had an invasive procedure versus non-exposed women (91% [38/42]; odds ratio: 0.11; 95% confidence interval: 0.03-0.35). In OS-1, more rFVIIa-exposed women (58% [22/38]) had an invasive procedure versus non-exposed women (35% [13.3/38]; odds ratio: 2.46; 95% confidence interval: 1.06-5.99). In OS-2, 17% (3/18) of rFVIIa-exposed women and 32% (5.6/17.8) of non-exposed women had an invasive procedure (odds ratio: 0.33; 95% confidence interval: 0.03-1.75). Across all included women, TEs occurred in 1.5% (0.2% arterial and 1.2% venous) of rFVIIa-exposed women and 1.6% (0.2% arterial and 1.4% venous) of non-exposed women with available data. Conclusions: The positive treatment effect of rFVIIa on the RCT was not confirmed in the OS. However, the safety analysis did not show any increased incidence of TEs with rFVIIa treatment.