IV administration of recombinant factor VII rapidly corrects warfarin anticoagulation

Saturday, February 07, 2004

Researchers at Mayo Clinic in Jacksonville, Fla., concluded that intravenous (IV) administration of recombinant factor VII quickly corrected warfarin anticoagulation in a series of patients with intracranial bleeding.

People prone to blood-clot formation take the anticoagulant medication warfarin. A rare, but life-threatening complication is intracranial bleeding, or hemorrhaging.

"People take warfarin to prevent stroke from atrial fibrillation," says Dr. James Meschia, a neurologist at Mayo Clinic who participated in the recombinant factor VII study. "It's a two-edged sword. Statistically you're better off taking the warfarin. But if you're one of the unlucky ones who bleeds into the head, you have a 50-percent chance of dying."

Meschia and his colleagues conducted a retrospective study of seven patients with intracranial hemorrhaging caused by warfarin anticoagulation. These seven received IV administration of a relatively new drug, recombinant factor VII. "The customary way to reverse the blood thinning is to give fresh frozen plasma and blood products," Meschia says. "But that takes hours, and sometimes you don't have hours. We gave recombinant factor VII as an IV injection that takes five to 10 minutes to administer. It reversed the anticoagulation much, much quicker."

Meschia says the patients in the study seemed to function better than what would typically be expected after the hemorrhage. But he cautions that large, randomized trials are needed to prove those observations.

Meschia presented results of this case study series at the American Stroke Association's 29th International Stroke Conference, Feb. 5-7, in San Diego.

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