Real World Experience with use of Coagulation Factor VIIa at an Academic Medical Center
Recommended Citation
George AR, Sylvester KW, Kanaan DM, Reddy P, Fanikos JR, Connors JM, and Connell NT. Real World Experience with use of Coagulation Factor VIIa at an Academic Medical Center. Clin Appl Thromb Hemost 2025;31.
Document Type
Article
Publication Date
12-11-2025
Publication Title
Clinical and applied thrombosis/hemostasis
Keywords
Humans, Factor VIIa, Retrospective Studies, Male, Recombinant Proteins, Academic Medical Centers, Middle Aged, Female, Hemophilia A, Adult, Hemorrhage, Aged
Abstract
Background: Eptacog alfa and eptacog beta are recombinant factor VIIa (rFVIIa) agents approved for use in hemophilia A or B with inhibitors. Our institution converted from eptacog alfa to eptacog beta as the preferred rFVIIa product. The objective of this medication use evaluation was to review the utilization of both agents and cost savings associated with the conversion.
Methods: We performed a retrospective chart review for all eptacog alfa and beta administrations from October 2023 through September 2024. We evaluated product selection and dosing as well as the occurrence of thrombosis, new bleeding events, or existing bleeding that required therapy escalation. Cost savings were estimated using wholesale acquisition costs.
Results: There were 17 patients that required 27 admissions for rFVIIa (eptacog alfa: 3, 11.1% and eptacog beta: 21, 77.8%). Three administrations (11.1%) utilized both agents. Indications included bleeding in hemophilia patients (12, 44.4%), followed by peri-procedural management (9, 33.3%), cardiac surgery (3, 11.1%), and anticoagulation reversal for life-threatening bleeding (3, 11.1%). There were 21 administrations in which eptacog beta was exclusively used (bleeding in hemophilia A (9, 33.3%), peri-procedural management (7, 25.9%), cardiac surgery (2, 7.4%), and anticoagulation reversal (3, 11.1%)). There were no thrombotic events. There were 5 patients (18.5%) who required rFVIIa dose escalation and two (7.4%) who required re-initiation of rFVIIa. Cost avoidance was estimated at $554,400 over a 12-month period.
Conclusion: We treated a small cohort of patients with eptacog beta without adverse outcomes. Other hospitals might evaluate their rFVIIa use and consider opportunities for substitution.
Medical Subject Headings
Humans; Factor VIIa; Retrospective Studies; Male; Recombinant Proteins; Academic Medical Centers; Middle Aged; Female; Hemophilia A; Adult; Hemorrhage; Aged
PubMed ID
41379429
Volume
31
First Page
10760296251405425
Last Page
10760296251405425
