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All About Bleeding

Fibrinogen (Factor I) Deficiencies

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CSL Behring & Therapies

Coagulation therapy is the foundation of CSL Behring’s broad range of therapies.

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Treatment

Fibrinogen (factor I) replacement therapy is used in the following situations:13

  • Treating spontaneous bleeding (treatment aims to achieve plasma fibrinogen levels of at least 1 g/l or at least 1.5 g/l to treat bleeding during major episodes, such as central nervous system (CNS) bleeding 7
  • Preventing perioperative bleeding (surgery, dentistry, other invasive interventions), and bleeding associated with childbirth
  • Preventing bleeding in individuals at risk (dose every 2–4 weeks), for example, following a CNS bleed (secondary prophylaxis) or to prevent early placental, ante- and post-partum bleeding during pregnancy
The table below summarizes the three types of products available for replacement fibrinogen therapy.

Fibrinogen concentrate 13-14, 15 Cryoprecipitate 13, 14 Fresh frozen plasma 11, 16
  • High purity concentrate of the deficient factor
  • Clinical experience limited but growing with wider availability and increasing evidence base
  • Dedicated viral inactivation steps in manufacturing process minimize risk of pathogen transmission
  • Offers standard fibrinogen content for accurate dosing
  • Thawing not required
  • Development of thrombosis is very rare
  • The mainstay of treatment when fibrinogen concentrate is unavailable
  • Variable fibrinogen content, and risk of hypercoagulability due to high amounts of factor VIII
  • Typically, 10 single bags needed to raise plasma fibrinogen level by 0.3 to 1g/l (depending on fibrinogen concentration) in an adult
  • No viral inactivation process; risk of pathogen transmission from donor to patient, particularly blood-borne viruses
  • Some risk of adverse reactions such as transfusion-related acute lung injury (TRALI)
  • Must be thawed, delaying infusion time
  • Low levels of fibrinogen mean large volume must be given to patient, risking hypervolemia, TRALI and other side effects
  • Considered inappropriate for replacing fibrinogen in many countries

CSL Behring Products

For more information about Factor I deficiency treatment options, please visit the following resources*:

Package Inserts

Product Websites

RiaSTAP.com (United States)

*Not all products are available in every country. To learn what products are available in your country, visit your CSL Behring country site.


Last Updated: 4/23/2015 4:28 PM
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