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Are all fibrinogen concentrates the same? The effects of two fibrinogen therapies in an afibrinogenemic patient and in a fibrinogen deficient plasma model: a clinical and laboratory case report.

Goodarzi, Soutiam; Abu-Hanna, Jeries; Harper, Sarah; Khan, Dalia; Morrow, Gael; Curry, Nicola

Authors

Soutiam Goodarzi

Jeries Abu-Hanna

Sarah Harper

Dalia Khan

Nicola Curry



Abstract

The choice of treatments for inherited, or acquired, fibrinogen deficient states is expanding and there are now several fibrinogen concentrate therapies commercially available. Patients with the rare inherited bleeding disorder, afibrinogenemia, commonly require life-long replacement therapy with fibrinogen concentrate to prevent hemorrhagic complications. Recent reports in the setting of acquired bleeding, namely trauma hemorrhage, have highlighted the potential importance of the different compositions of fibrinogen supplements, including cryoprecipitate and the various plasma- derived concentrates. Clot strength and the subsequent susceptibility of a clot to lysis is highly dependent on the amount of fibrinogen as well as its structural composition, the concentration of pro- and anti-coagulant factors, as well as fibrinolytic regulators, such as factor XIII (FXIII). This report details the effects of two commercially available fibrinogen concentrates (Riastap®, CSL Behring and Fibryga®, Octapharma) on important functional measures of clot formation and lysis in a patient with afibrinogenemia. Our report offers insights into the differential effects of these concentrates, at the clot level, according to the variable constituents of each product, thereby emphasizing that the choice of fibrinogen concentrate can influence the stability of a clot in vivo. Whether this alters clinical efficacy is yet to be understood.

Citation

GOODARZI, S., ABU-HANNA, J., HARPER, S., KHAN, D., MORROW, G. and CURRY, N. 2024. Are all fibrinogen concentrates the same? The effects of two fibrinogen therapies in an afibrinogenemic patient and in a fibrinogen deficient plasma model: a clinical and laboratory case report. Frontiers in medicine [online], 11, article 1391422. Available from: https://doi.org/10.3389/fmed.2024.1391422

Journal Article Type Article
Acceptance Date May 15, 2024
Online Publication Date May 30, 2024
Publication Date Dec 31, 2024
Deposit Date May 30, 2024
Publicly Available Date Jun 3, 2024
Journal Frontiers in medicine
Electronic ISSN 2296-858X
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Volume 11
Article Number 1391422
DOI https://doi.org/10.3389/fmed.2024.1391422
Keywords Afibrinogenemia; Fibrinogen concentrate; Hemostasis; Inherited bleeding disorder; Fibrinolysis
Public URL https://rgu-repository.worktribe.com/output/2349209
Additional Information This article has been published with separate supporting information. This supporting information has been incorporated into a single file on this repository and can be found at the end of the file associated with this output.

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Publisher Licence URL
https://creativecommons.org/licenses/by/4.0/

Copyright Statement
© 2024 Goodarzi, Abu-Hanna, Harper, Khan, Morrow and Curry. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).





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