Prothrombinex-VF® for coagulopathy of liver disease in acutely bleeding patients; Too much of a good thing?

Grant ID: EMLE-233R38-2022-LATONA

Project Summary

Chronic liver disease (CLD) is prevalent in Australian society and is the 11th leading cause of premature death (1). Thirty eight percent of patients experience gastrointestinal bleeding (GI) as a complication(2). The underlying balance between bleeding and clotting tendency is altered in chronic liver disease, making management of acute bleeding challenging in the emergency setting(3). There is a lack of high-quality evidence to guide the best combination of blood products and other medications to stop bleeding(4).

Prothrombinex®-VF is a blood product which can help to improve the level of clotting factors in the body thereby reducing bleeding tendency. It is indicated for anticoagulant reversal in acute bleeding(5). In practice many emergency physicians have used the product for patients with chronic liver disease who present with acute bleeding, although it is not licensed for this indication(6).

A retrospective Queensland study performed by this author showed that half of Prothrombinex®-VF usage for liver disease was in the emergency department by emergency physicians. It suggested that the product makes little impact on reversal of laboratory blood clotting tests and it raised important safety concerns regarding the develop of a syndrome of accelerated bleeding and clotting concurrently(6).

This expanded statewide audit of Prothrombinex®-VF in chronic liver disease in Queensland seeks to define efficacy and safety of the product. There is no statewide guideline for Prothrombinex®-VF and this data will contribute valuable information to developing future guidance for clinicians.


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Amount Awarded
$100,000


Program


Grant Scheme


Status
Active


Principal Investigator:
Dr Akmez Latona


Co Investigators:
Dr Kate Hill


Associate Investigators:
Dr Alex King
Dr Rachel Wooldridge
Dr Sara Towle
Dr Andrew Brier
Dr Matthew Harwood
Dr Hock Lai
Dr Rajesh Mamadigi
Dr Georgia Livesay
Dr Jason Conn
Dr Katherine Stuart
Dr Kent Perkins
Dr Joanne Perel


Institution


Collaborating Institutions


CONTACT US +61 7 3112 8668 info@emfoundation.org.au Suite 1A 34 Sherwood Road Toowong, Qld 4066