Comparative Effectiveness of In-Hospital Use of Recombinant Factor VIIa for Off-Label Indications vs. Usual Care
Overview of rFVIIa for Adult Cardiac Surgery: Clinical Outcomes
The strength of evidence was low for the findings of no effect of rFVIIa use on mortality, units of RBCs transfused, or ICU length of stay. Among the RCTs and higher quality cohort studies, there was a trend toward reduced transfusion requirements with therapy, but no difference in ICU length of stay. Study patients were similar in age to those in the Premier database. Compared to Premier patients, those in the cohort studies had comparable mortality rates, whereas those in the RCTs had somewhat lower mortality rates. The importance and nature of interactions between the timing of treatment use of rFVIIa and important clinical outcomes remain uncertain.
- Diprose P, Herbertson MJ, O’Shaughnessy D, et al. Activated recombinant factor VII after cardiopulmonary bypass reduces allogeneic transfusion in complex non-coronary cardiac surgery: randomized double-blind placebo-controlled pilot study. Br J Anaesth 2005;95:596-602.
- Gelsomino S, Lorusso R, Romagnoli S, et al. Treatment of refractory bleeding after cardiac operations with low-dose recombinant activated factor VII (NovoSeven): a propensity score analysis. Eur J Cardiothorac Surg 2008;33:64-71.
- Gill R, Herbertson M, Vuylsteke A, et al. Safety and efficacy of recombinant activated factor VII: a randomized placebo-controlled trial in the setting of bleeding after cardiac surgery. Circulation 2009;120:21-7.
- Karkouti K, Beattie WS, Wijeysundera DN, et al. Recombinant factor VIIa for intractable blood loss after cardiac surgery: a propensity score-matched case-control analysis. Transfusion 2005;45:26-34.
- Tritapepe L, De Santis V, Vitale D, et al. Recombinant activated factor VII for refractory bleeding after acute aortic dissection surgery: a propensity score analysis. Crit Care Med 2007;35:1685-90.
- Yank V, Tuohy CV, Logan AC, et al. Comparative Effectiveness of In-Hospital Use of Recombinant Factor VIIa for Off-Label Indications vs. Usual Care, Comparative Effectiveness Review 21 (Prepared by Stanford–UCSF Evidence-based Practice Center under Contract No. 290-02-0017). Rockville, MD: Agency for Healthcare Research and Quality; May 2010. AHRQ Publication No. 10-EHC030-EF.
Your slide tray is being processed.