Table 2.

Hemostatic Therapies for Management of Bleeding in Acquired Hemophilia

Agent	Dosing	Lab Monitoring	Comments
Recombinant Porcine Factor VIII	200 units/kg to achieve factor VIII 100–200% then titrate subsequent doses every 4–12 hours to maintain favor VIII trough 50% after acute bleed is controlled42 Alternative: 100 units/kg with factor VIII monitoring every 2–3 hours and re-dosing based on VIII level50	One-stage factor VIII assay	Porcine factor VIII inhibitor titers may predict response
Recombinant Factor VIIa	70–90 mcg/kg every 2–4 hours until hemostasis is obtained and then prolong interval42	None	Recombinant VIIa can shorten INR significantly. This may cause artificially elevated INR >10 to be reported by some clinical assays. Potential thrombosis risk
Activated Prothrombin Complex Concentrate	50–100 U/kg every 8–12 hours	None	Potential thrombosis risk

Notes: Adapted from Kruse-Jarres R, Kempton CL, Baudo F, et al. Acquired hemophilia A: updated review of evidence and treatment guidance. Am J Hematol. 2017;92(7):695–705. with permission from  © 2017 Wiley Periodicals, Inc.⁴²