Antihemophilic Factor Factor 8 (AHF )

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

  1. bleeding prophylaxis
  2. hemophilia A
  3. hemorrhage
  4. surgical bleeding
  5. 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

  1. abdominal pain
  2. anaphylactic shock
  3. anaphylactoid reactions
  4. angina
  5. angioedema
  6. anorexia
  7. antibody formation
  8. arthralgia
  9. asthenia
  10. bleeding
  11. bradycardia
  12. bronchospasm
  13. chills
  14. cough
  15. cyanosis
  16. diarrhea
  17. dizziness
  18. drowsiness
  19. dysgeusia
  20. dyspnea
  21. edema
  22. elevated hepatic enzymes
  23. epistaxis
  24. erythema
  25. fatigue
  26. fever
  27. flushing
  28. headache
  29. hemolysis
  30. hemolytic anemia
  31. hepatitis
  32. hyperbilirubinemia
  33. hyperhidrosis
  34. hypotension
  35. infection
  36. injection site reaction
  37. myalgia
  38. nasal congestion
  39. nausea
  40. orthostatic hypotension
  41. pallor
  42. palpitations
  43. pancreatitis
  44. paresthesias
  45. peripheral edema
  46. peripheral vasodilation
  47. pharyngitis
  48. phlebitis
  49. pruritus
  50. pulmonary embolism
  51. rash
  52. rhinorrhea
  53. seizures
  54. sinus tachycardia
  55. thrombocytopenia
  56. thrombocytosis
  57. thromboembolism
  58. thrombosis
  59. tremor
  60. urticaria
  61. vomiting
  62. 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
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