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Antihemophilic Factor (Factor 8) Brand Names
Advate | Adynovate | AFSTYLA | Alphanate | Bioclate | ESPEROCT | Helixate | Helixate FS | Hemofil M | Humate-P | Jivi | Koate | Koate-DVI | Kogenate | Kogenate FS | Kovaltry | Monarc-M | Monoclate-P | Novoeight | Nuwiq | Recombinate | ReFacto | Wilate vonWillebrand | XYNTHA | XYNTHA Solofuse
What is Antihemophilic Factor
Antihemophilic factor (AHF), also known as factor 8, is a parenteral coagulation factor indicated for perioperative management and on-demand treatment of bleeding in patients with von Willebrand’s disease (vWD) and for perioperative management and prophylactic or on-demand treatment of bleeding in patients with hemophilia A.
Factor 8 concentrates are the treatment of choice for hemophilia A.
Plasma-derived von Willebrand factor (vWF)-containing factor VIII concentrates are used in certain types of vWD that do not respond to desmopressin, as well as in surgical situations.
Reduction in vWF results in a correspondingly low factor VIII activity, making replacement of both important in vWD.
Both plasma-derived and recombinant concentrates are suitable for the management of bleeding disorders; screening plasma donors, testing for viral presence, viral inactivation and/or reduction have improved the safety of plasma-derived products.
The development of factor replacement products with prolonged half-lives improves patient adherence by enabling less frequent infusions, decreasing the bleeding rate, and reducing the burden of treatment.
Several technologies have been applied to extend the half-life of factor 8, including the addition of polyethylene glycol (PEG) to factor 8.
The most serious iatrogenic complication of hemophilia treatment is the development of factor inhibitors, which causes neutralization of the infused factor. Inhibitors are more common in hemophilia A, developing in up to 30% of patients.
In comparison, the incidence in those with hemophilia B is approximately 5%.
In patients with vWD, an excessive rise in factor VIII activity may increase the risk of thromboembolism.
Assess each patient’s risk of thrombosis, monitor plasma vWF:RCo and factor VIII activities, and institute appropriate antithrombotic measures in patients receiving coagulation factor replacement therapy as necessary.
Indications
- bleeding prophylaxis
- hemophilia A
- hemorrhage
- surgical bleeding
- von Willebrand’s disease
For the on-demand treatment and control of hemorrhage in patients with hemophilia A (classical hemophilia)
NOTE: Kogenate FS and Xyntha have been designated by the FDA as orphan drugs for this indication.
NOTE: Factor VIII concentration may be expressed as % or International Units/dL.
Side Effects
- abdominal pain
- anaphylactic shock
- anaphylactoid reactions
- angina
- angioedema
- anorexia
- antibody formation
- arthralgia
- asthenia
- bleeding
- bradycardia
- bronchospasm
- chills
- cough
- cyanosis
- diarrhea
- dizziness
- drowsiness
- dysgeusia
- dyspnea
- edema
- elevated hepatic enzymes
- epistaxis
- erythema
- fatigue
- fever
- flushing
- headache
- hemolysis
- hemolytic anemia
- hepatitis
- hyperbilirubinemia
- hyperhidrosis
- hypotension
- infection
- injection site reaction
- myalgia
- nasal congestion
- nausea
- orthostatic hypotension
- pallor
- palpitations
- pancreatitis
- paresthesias
- peripheral edema
- peripheral vasodilation
- pharyngitis
- phlebitis
- pruritus
- pulmonary embolism
- rash
- rhinorrhea
- seizures
- sinus tachycardia
- thrombocytopenia
- thrombocytosis
- thromboembolism
- thrombosis
- tremor
- urticaria
- vomiting
- wheezing
Monitoring Parameters
- clotting inhibitor titers
- factor VIII concentrations
- von Willebrand’s factor activity
Contraindications
- anemia
- bovine protein hypersensitivity
- breast-feeding
- cardiac disease
- factor VIII inhibitors
- hamster protein hypersensitivity
- hepatitis
- human immunodeficiency virus (HIV) infection
- infection
- latex hypersensitivity
- mannitol hypersensitivity
- murine protein hypersensitivity
- polysorbate 80 hypersensitivity
- pregnancy
- thromboembolic disease
- viral infection
Interactions
- Emicizumab
- Factor VIIa, Recombinant