George, we had a patient recently who was on Autoplex and his Dr. ordered a PTT. I am not familiar with Autoplex, can you give me some information or direct me to a website? Thank you.
Yvonne Ellis MT (ASCP)
Bedford Regional Medical Center
Hi, Yvonne. Great question. Autoplex T (Nabi, Inc) is an activated prothrombin complex concentrate, a competitor to Baxter’s FEIBA (factor eight inhibitor bypassing activity), and to Novo Nordisk’s NovoSeven (recombinant factor VIIa). All three are used for boys and men with hemophilia A (factor VIII deficiency) who have developed a factor VIII inhibitor, are bleeding, and are refractory to factor VIII concentrate therapy. Because Autoplex T and FEIBA contain activated factors IIa, VIIa, IXa and Xa, they raise the risk of DIC, so there are limits placed upon their dosages. NovoSeven does not cause DIC, but it is strikingly more expensive.
There are no laboratory assays that can monitor the plasma activity of Autoplex T, FEIBA, or NovoSeven, but physicians typically order the PTT, which shortens to near the reference interval as coagulation normalizes. The normalizing PTT predicts the cessation of bleeding. I’ve attached a link to Nabi’s package insert below. Geo.
Hello. Can you explain me a little more about this? Sorry fo
Hello. Can you explain me a little more about this? Sorry for my English I’m only a Chango Argentino!
Hello, DF Moreno, and thank you again for your question. As a typical US citizen, I regret I am limited to English, and my Spanish to English dictionary doesn’t provide me with a definition for chango. Please help me with this.
Autoplex and FEIBA are the activated factor IX complexes, first developed in 1980. These are human plasma-derived preparations in which normal plasma is treated with barium sulfate or aluminum hydroxide to separate factors II, VII, IX and X. The earliest preparation was Proplex, used for boys with factor IX deficiency before there was a factor IX concentrate. Proplex is still available, but it is Autoplex or FEIBA that are used for boys or men with either factor VIII or factor IX deficiencies who develop inhibitors (IgG antibodies) to therapeutic factor VIII or IX and fail to respond to standard treatment. Autoplex and FEIBA, because they provide activated factors II, VII, IX, and X, are able to bypass the effects of the inhibitor. Both are used a lot in hemophilia centers around the world, although many physicians prefer NovoSeven, recombinant activated factor VII because it is safer. I hope this helps.
TEG with kaolin is the best option for monitor
TEG with kaolin is the best option for monitoring all bypassing agents for treatment of Hemophilia monitoring. Vilas Hiremath