Key result
Recombinant FVIII infusion did not significantly change platelet function in patients with severe hemophilia A on prophylaxis, but decreased endothelial microvesicles.
Why the study?
To evaluate the role of platelets and microvesicles in severe hemophilia A patients on prophylaxis, and whether coagulation factor FVIII administration modifies this hemorrhagic phenotype.
Does recombinant FVIII infusion modify platelet function and microvesicle generation in patients with severe hemophilia A on prophylaxis?
Observational (n=31)
Does recombinant FVIII infusion modify platelet function and microvesicle generation in patients with severe hemophilia A on prophylaxis?
Prophylactic administration of recombinant FVIII in severe hemophilia A does not alter platelet function but may reduce endothelial microvesicles, suggesting no increase in this thrombotic risk marker.
FVIII leaves platelet function unchanged in prophylaxed severe HA; leaves open whether reduced endothelial microvesicles modify bleeding or thrombotic risk.
Aim: In the present work we have studied the role of platelets and microvesicles in patients with severe hemophilia A (HA) treated under the regimen of prophylaxis. We have analyzed whether the administration of coagulation factor FVIII modifies this hemorrhagic phenotype in a cohort of 16 patients with diagnosis of severe HA, who were on prophylactic treatment with recombinant FVIII. Methods: Blood tests were performed before (72h without FVIII, baseline sample) and after 15 minutes of FVIII infusion. As a control group, 15 healthy subjects were studied. Platelet aggregation was determined by closure time, optical aggregation, impedance aggregation and flow cytometry. We also studied the expression of the platelet activation markers P-selectin, CD63, platelet-tissue factor, formation of platelet-leukocyte aggregates and tissue factor exposure. The total number of platelet and endothelial microvesicles were also analyzed by flow cytometry, as well as platelet cytosolic Ca2+ mobilization. Results: We found no significant differences in platelet function in patients with severe HA in prophylactic treatment before and after FVIII infusion. After FVIII administration, patients presented fewer endothelial microvesicles, indicating that the treatment does not increase one of the possible thrombotic risk markers of these patients. The total amount of plasma microvesicles and the platelet microvesicles were decreased in patients with HA compared to the control group. Conclusions: Our results do not support any effect of FVIII on platelet function in patients with severe HA treated under the regime of prophylaxis.
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Melero‐Amor et al. (2020) conducted an observational in Severe hemophilia A (n=31). Recombinant FVIII infusion vs. Baseline (72h without FVIII) and healthy controls was evaluated on Platelet function and microvesicles generation. Recombinant FVIII infusion did not significantly change platelet function in patients with severe hemophilia A on prophylaxis, but decreased endothelial microvesicles.
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