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Studies document risky use of powerful clotting drug


What happens when physicians latch onto a "wonder" drug for uses that are distinctly different from its original purpose? Stanford researchers today showcase a clear example of the harm that can potentially be done to patients.

In a pair of studies published in the Annals of Internal Medicine, the Stanford team documents the use of recombinant factor 7a - a powerful clotting drug that was intended for a subgroup of hemophilia patients. However, the researchers estimate that in U.S. hospitals from 2000 through 2008, only 4 percent of the drug's use was for treating hemophilia patients. A staggering 96 percent of the drug's use involved cases of heart surgery, trauma, brain hemorrhages and a host of other surgical and medical problems.

The team also found that the use of RF7a increased the risk of blood clots without improving the mortality rates. What’s more, RF7a is pricey - it costs an estimated $10,000 for an average dose.

As first author Veronica Yank, MD, notes in our news release, "The stakes are high with this one. Because it’s such a powerful clotting agent, it has the potential when used off-label to damage the lives of patients without providing any real benefit.”

An accompanying editorial by Harvard researchers commends the Stanford team for providing “compelling data about the runaway use, uselessness and risk for this expensive treatment.”

Yank says she hopes the two studies will prompt physicians and surgeons to be more cautious about the off-label use of RF7a. “Despite the miraculous ability of this drug to stop bleeding, we have an obligation to ‘first do no harm,’” she says.

Photo by Steve Fisch

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