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Recombinant factor VIIa (rFVIIa) is a potent procoagulant that directly activates factor X on the platelet surface, bypassing the requirement for factor VIII and several other factors in the coagulation cascade. It is FDA approved for the treatment of bleeding due to FVIII inhibitors but has been used off-label to control hemorrhage in many other clinical situations. Now, researchers have conducted two studies to determine patterns and efficacy of off-label rFVIIa use.
In the first study, investigators reviewed 12,644 discharge records of patients who received rFVIIa at 615 hospitals from 2000 through 2008. During that period, off-label use of rFVIIa increased more than 140-fold. During 2008, 97% of all uses were for off-label indications; t…