In vivo recovery of factor VIII and factor IX: intra- and interindividual variance in a clinical setting

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Björkman, Sven E.Uppsala universitet,Avdelningen för farmakokinetik och läkemedelsterapi,MHU (author)

In vivo recovery of factor VIII and factor IX : intra- and interindividual variance in a clinical setting

Article/chapterEnglish2007

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Wiley,2007
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LIBRIS-ID:oai:DiVA.org:uu-23493
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-23493URI
https://doi.org/10.1111/j.1365-2516.2006.01401.xDOI
https://lup.lub.lu.se/record/165066URI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

Notes

In vivo recovery (IVR) is traditionally used as a parameter to characterize the pharmacokinetic properties of coagulation factors. It has also been suggested that dosing of factor VIII (FVIII) and factor IX (FIX) can be adjusted according to the need of the individual patient, based on an individually determined IVR value. This approach, however, requires that the individual IVR value is more reliably representative for the patient than the mean value in the population, i.e. that there is less variance within than between the individuals. The aim of this investigation was to compare intra- and interindividual variance in IVR (as U dL−1 per U kg−1) for FVIII and plasma-derived FIX in a cohort of non-bleeding patients with haemophilia. The data were collected retrospectively from six clinical studies, yielding 297 IVR determinations in 50 patients with haemophilia A and 93 determinations in 13 patients with haemophilia B. For FVIII, the mean variance within patients exceeded the between-patient variance. Thus, an individually determined IVR value is apparently no more informative than an average, or population, value for the dosing of FVIII. There was no apparent relationship between IVR and age of the patient (1.5–67 years). For FIX, the mean variance within patients was lower than the between-patient variance, and there was a significant positive relationship between IVR and age (13–69 years). From these data, it seems probable that using an individual IVR confers little advantage in comparison to using an age-specific population mean value. Dose tailoring of coagulation factor treatment has been applied successfully after determination of the entire single-dose curve of FVIII:C or FIX:C in the patient and calculation of the relevant pharmacokinetic parameters. However, the findings presented here do not support the assumption that dosing of FVIII or FIX can be individualized on the basis of a clinically determined IVR value.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Medicinska och farmaceutiska grundvetenskaper Farmaceutiska vetenskaper hsv//swe
MEDICAL AND HEALTH SCIENCES Basic Medicine Pharmaceutical Sciences hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Hematologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Hematology hsv//eng
dosing
factor VIII
factor IX
in vivo recovery
pharmacokinetics
variance
PHARMACY
FARMACI
in vivo recovery
dosing
factor VIII
pharmacokinetics
variance
factor IX

Added entries (persons, corporate bodies, meetings, titles ...)

Folkesson, AnnaUppsala universitet,Avdelningen för farmakokinetik och läkemedelsterapi,MHU (author)
Berntorp, ErikLund University,Lunds universitet,Klinisk koagulationsmedicin, Malmö,Forskargrupper vid Lunds universitet,Clinical Coagulation, Malmö,Lund University Research Groups(Swepub:lu)medf-ebe (author)
Uppsala universitetAvdelningen för farmakokinetik och läkemedelsterapi (creator_code:org_t)

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In:Haemophilia: Wiley13:1, s. 2-81351-82161365-2516

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Basic Medicine; and Pharmaceutical S ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Hematology

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