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Learn to spot the signs of acquired hemophilia.

Patients with acquired hemophilia may have no personal or family history of bleeding.1 It is critical that urgent lab tests are performed when unexplained bleeding occurs in patients with no bleeding history.

What are the signs of acquired hemophilia?

Approximately 70% of patients experience severe, unexplained bleeding at diagnosis, with bleeding patterns varying widely. Delayed diagnosis is common for acquired hemophilia, which puts patients at higher risk of bleeding complications.2,3

What are the signs of acquired hemophilia?

Approximately 70% of patients experience severe, unexplained bleeding at diagnosis, with bleeding patterns varying widely. Delayed diagnosis is common for acquired hemophilia, which puts patients at higher risk of bleeding complications.2,3

Pay attention to patients with the following symptoms:

Isolated prolonged activated partial thromboplastin time (aPTT)2

Isolated prolonged activated partial thromboplastin time (aPTT)2


Bleeding sites atypical of congenital hemophilia3

Bleeding sites atypical of congenital hemophilia3


Purpura (bruising) and soft-tissue hemorrhage2


Gastrointestinal, urological, or retroperitoneal bleeding1,4


Prolonged bleeding following surgery2


Postpartum bleeding1


Compartment syndrome (compression of blood vessels and nerves)1,5

Don't confuse an isolated, elevated PTT for lupus anticoagulant, particularly if the clinical symptoms don't make sense. 

How do patients with acquired hemophilia generally present?

Early diagnosis may save lives.6,7

acquired hemophilia test result parameters

aPTT=activated partial thromboplastin time; PT=prothrombin time.

When lab results in a bleeding patient show an unexplained, isolated, prolonged aPTT, consult a hematologist immediately.1,3

Recommended lab testing to confirm the diagnosis of acquired hemophilia.3

algorithm for diagnosing acquired hemophilia
algorithm for diagnosing acquired hemophilia

Adapted from Collins et al.3  

NovoSevenRT vials and dosing

Need dosing information for

acquired hemophilia patients?


Acquired hemophilia patient displaying a bruised shoulder

Approved for bleed

management and surgical use

in acquired hemophilia.


clinical pathway for treating emergent bleeds and acquired hemophilia in emergency department

Review an example of treating

acquired hemophilia with

inhibitors in the emergency department.

Selected Important Safety Information

WARNING: THROMBOSIS

  • Serious arterial and venous thrombotic events following administration of NovoSeven® RT have been reported
  • Discuss the risks and explain the signs and symptoms of thrombotic and thromboembolic events to patients who will receive NovoSeven® RT
  • Monitor patients for signs or symptoms of activation of the coagulation system and for thrombosis

Warnings and Precautions

  • Serious arterial and venous thrombotic events have been reported in clinical trials and postmarketing surveillance
  • Patients with congenital hemophilia receiving concomitant treatment with aPCCs (activated prothrombin complex concentrates), older patients particularly with acquired hemophilia and receiving other hemostatic agents, and patients with a history of cardiac and vascular disease may have an increased risk of developing thrombotic events

Indications and Usage

NovoSeven® RT (coagulation Factor VIIa, recombinant) is a coagulation factor indicated for:

  • Treatment of bleeding episodes and perioperative management in adults and children with hemophilia A or B with inhibitors, congenital Factor VII (FVII) deficiency, and Glanzmann’s thrombasthenia with refractoriness to platelet transfusions, with or without antibodies to platelets
  • Treatment of bleeding episodes and perioperative management in adults with acquired hemophilia

Important Safety Information

WARNING: THROMBOSIS

  • Serious arterial and venous thrombotic events following administration of NovoSeven® RT have been reported
  • Discuss the risks and explain the signs and symptoms of thrombotic and thromboembolic events to patients who will receive NovoSeven® RT
  • Monitor patients for signs or symptoms of activation of the coagulation system and for thrombosis

Warnings and Precautions

  • Serious arterial and venous thrombotic events have been reported in clinical trials and postmarketing surveillance
  • Patients with congenital hemophilia receiving concomitant treatment with aPCCs (activated prothrombin complex concentrates), older patients particularly with acquired hemophilia and receiving other hemostatic agents, and patients with a history of cardiac and vascular disease may have an increased risk of developing thrombotic events
  • Hypersensitivity reactions, including anaphylaxis, can occur with NovoSeven® RT. Patients with a known hypersensitivity to mouse, hamster, or bovine proteins may be at a higher risk of hypersensitivity reactions. Discontinue infusion and administer appropriate treatment when hypersensitivity reactions occur
  • Factor VII deficient patients should be monitored for prothrombin time (PT) and factor VII coagulant activity (FVII:C). If FVII:C fails to reach the expected level, or PT is not corrected, or bleeding is not controlled after treatment with the recommended doses, antibody formation may be suspected and analysis for antibodies should be performed
  • Laboratory coagulation parameters (PT/INR, aPTT, FVII:C) have shown no direct correlation to achieving hemostasis

Adverse Reactions

  • The most common and serious adverse reactions in clinical trials are thrombotic events. Thrombotic adverse reactions following the administration of NovoSeven® RT in clinical trials occurred in 4% of patients with acquired hemophilia and 0.2% of bleeding episodes in patients with congenital hemophilia

Drug Interactions

  • Thrombosis may occur if NovoSeven® RT is administered concomitantly with Coagulation Factor XIII

Please click here for Prescribing Information

References:

  1. Huth-Kühne A, Baudo F, Collins P, et al. International recommendations on the diagnosis and treatment of patients with acquired hemophilia A. Haematologica. 2009;94(4):566-575.
  2. Collins PW, Percy CL. Advances in the understanding of acquired haemophilia A: implications for clinical practice. Br J Haematol. 2010;148(2):183-194.
  3. Collins, Baudo, Huth-Kühne, et al. Consensus recommendations for the diagnosis and treatment of acquired hemophilia A. BMC Res Notes. 2010;3:161.
  4. Collins PW, Hirsch S, Baglin TP, et al; for UK Haemophilia Centre Doctors’ Organisation. Acquired hemophilia A in the United Kingdom: a 2-year national surveillance study by the United Kingdom Haemophilia Centre Doctors’ Organisation. Blood. 2007;109(5):1870-1877.
  5. Giangrande P. Acquired Hemophilia: Revised Edition: Treatment of Hemophilia No. 38. Montréal, Québec: World Federation of Hemophilia; 2012:1-2.
  6. Collins PW. Therapeutic challenges in acquired factor VIII deficiency. Hematology Am Soc Hematol Educ Program. 2012;2012:369-374.
  7. Collins PW, Chalmers E, Hart D, et al; United Kingdom Haemophilia Centre Doctors’ Organization. Diagnosis and management of acquired coagulation inhibitors: a guideline from UKHCDO. Br J Haematol. 2013;162(6):758-773.
  8. Introduction to normal values (reference ranges). In: Wallach J, ed. Interpretation of Diagnostic Tests. 8th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007:3-25.