-Patients receiving oral anticoagulant treatment have abnormally low levels of functional
vitamin K-dependent coagulation proteins and consequently a clear risk of hemorrhagic
complications. The incidence of hemorrhages has been reported to be around 0.6-0.7%
per month at a therapeutic International Normalized Ratio (INR) and the incidence
of major hemorrhagic events is substantial. Therefore, the ability to reverse the
anti-vitamin K effect is of utmost importance, and if an immediate reversal is necessary,
plasma or prothrombin complex concentrates are used. As plasma-derived products carry
the risk of transmission of blood-borne viruses and also of thromboembolic complications,
it is desirable to test new potential tools for oral anticoagulant reversal. Recombinant
factor VIIa (FVIIa) has been tested in rats and humans treated with anti-vitamin K
drugs with seemingly good effect on hemostasis and laboratory parameters. Even if
more data are needed before any definite conclusions can be drawn, the outlook so
far seems promising.
rFVIIa - warfarin - vitamin K - hemorrhage - coagulation
