Retrospective analysis of in vivo recovery and clearance during continuous infusion of recombinant factor VIII products: a single-institution study.
BACKGROUND
Continuous infusion (CI) of recombinant FVIII (rFVIII) concentrates has been reported as an effective and safe method to achieve haemostasis during major surgeries or severe bleeding events. For more effective and safer CI, better understanding of in vivo recovery (IVR) and clearance (CL) issues is imperative.


OBJECTIVE
We investigated the following factors affecting IVR and CL using univariate and multivariate regression analyses during 47 CIs in 34 patients: rFVIII concentrate type, haemophilia severity, blood type, the presence of hepatitis C virus (HCV) or human immunodeficiency virus (HIV), age and body mass index (BMI).


RESULTS
The mean IVR was 1.64 ± 0.49 IU dL-1 per IU kg-1 , and the mean CL during CI was 3.56 ± 1.57 mL h-1 kg-1 . The univariate and multivariate regression analyses showed that the CL of octocog alfa was significantly lower than that of rurioctocog alfa (P = 0.043 and 0.0034, respectively). There was a significant difference in BMI in the univariate and multivariate regression analyses (P = 0.0403 and 0.0376, respectively).


CONCLUSIONS
This study indicated that CL during CI was potentially affected by the type of rFVIII concentrate used and BMI.
['Suzuki|N|N|', 'Hirakawa|A|A|', 'Kishimoto|M|M|', 'Kanematsu|T|T|', 'Ogawa|M|M|', 'Kiyoi|H|H|', 'Matsushita|T|T|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D005169:Factor VIII D006801:Humans D007260:Infusion Pumps D008875:Middle Aged D011994:Recombinant Proteins D012189:Retrospective Studies D055815:Young Adult
in vivo recovery clearance factor VIII haemophilia A pharmacokinetics