Successful intraosseous factor VIII application in a haemophilic emergency

J Clin Pharm Ther. 2021 Feb;46(1):212-214. doi: 10.1111/jcpt.13252. Epub 2020 Aug 29.

Abstract

What is known and objectives: Intravenous (IV) replacement therapy with plasma derived or recombinant factor VIII (FVIII) and factor IX concentrates is the mainstay for treatment of patients with haemophilia A and B. Therefore, the current therapy is particularly dependent on the presence of a secure IV access especially in case of emergency.

Case description: A life-threatening bleeding event in an 8-month-old boy is managed by intraosseous (IO) infusion of recombinant FVIII concentrate. No adverse events have been observed 6 months after the application, and complete heeling has been reported.

What is new and conclusion: Venous application of factor concentrate remains inevitable in any haemophilic emergency. In case IV access is lacking, an IO institution of factor might be considered. To our knowledge, this represents the first reported case of IO application of recombinant FVIII concentrate in a patient with haemophilia.

Keywords: factor VIII; haemophilia; haemophilic emergency; intraosseous application.

Publication types

  • Case Reports

MeSH terms

  • Factor VIII / administration & dosage
  • Factor VIII / therapeutic use*
  • Hemophilia A / drug therapy*
  • Humans
  • Infant
  • Infusions, Intraosseous
  • Male

Substances

  • Factor VIII