Patient blood management strategies have become increasingly important during the COVID-19 pandemic as the medical community has confronted the effects of decreasing blood supply. In fact, the American Red Cross recently declared the nation’s first-ever national blood crisis with the omicron variant surge, placing ever greater demands on blood product supply nationwide.1
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As omicron has spread nationally, Octapharma’s fibryga® and Octaplas™ have become Increasingly important replacement therapies. (Photo: Business Wire)
Medical providers should consider replacing cryoprecipitate and fresh frozen plasma with Octapharma USA’s Octaplas™, Pooled Plasma (Human), Solvent/Detergent (S/D) Treated Solution for Intravenous Infusion, and fibryga®, Fibrinogen (Human) Lyophilized Powder for Reconstitution. In addressing the tightening supply of blood products, the College of American Pathologists TACT (Transfusion, Apheresis, and Cellular Therapy) Committee has recommended that hospital transfusion services consider replacing products such as cryoprecipitate, if supplies become depleted, with alternative human plasma products.2
Octaplas™ and fibryga® are in good supply and readily available.
“The current blood shortage has created a need to utilize alternatives for plasma and cryoprecipitate, such as Octaplas™ and fibryga®,” said Melissa Cushing, M.D., an international expert in perioperative bleeding and patient blood management.3 “I have utilized a proactive approach to patient blood management that includes using these products to replace plasma and cryoprecipitate, as well as strict enforcement of transfusion guidelines and hosting blood drives.”
Many factors can impact the blood products supply chain, such as the number of donors, seasonal factors, and the ability of blood services to adequately predict needs throughout the year.4 Awareness of appropriate blood products ordering can help clinicians manage supply chain disruptions.
“The availability of Octapharma’s human plasma products affords our critical care partners the confidence to support patient needs,” said Octapharma USA President Flemming Nielsen. “At Octapharma, critical care medicine continues to be an important part of our therapeutic focus − and we are fully committed to supporting our healthcare partners with a reliable and sustainable product supply.”
About fibryga®
Fibryga®, Fibrinogen (Human) Lyophilized Powder for Reconstitution, for Intravenous Use, is a human fibrinogen concentrate indicated for the treatment of acute bleeding episodes in adults and children with congenital fibrinogen deficiency, including afibrinogenemia and hypofibrinogenemia. Fibryga® is not indicated for dysfibrinogenemia.
Contraindications
Fibryga® is contraindicated in individuals who have manifested severe immediate hypersensitivity reactions, including anaphylaxis, to fibryga® or its components.
Warnings and Precautions
Monitor patients for early signs of hypersensitivity or allergic reactions. If necessary, discontinue administration and institute appropriate treatment. Thrombotic events have been reported in patients receiving fibryga®. Treatment with human fibrinogen concentrate has been associated with thrombosis at target plasma fibrinogen levels that were below 150 mg/dL. The thrombotic risks may be greater when the target fibrinogen plasma level is 150 mg/dL. Weigh the benefits of administration versus the risks of thrombosis.
Fibryga® is made from pooled human plasma. Products made from human plasma may contain infectious agents, e.g., viruses and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent.
Adverse Events
The most serious adverse reactions that may be observed with fibryga® are thromboembolic episodes and anaphylactic type reactions. The most common adverse reactions observed in more than one subject in clinical studies with fibryga® (>5% of subjects) were nausea, vomiting, pyrexia (fever) and thrombocytosis.
About Octaplas™
Octaplas™ is a solvent/detergent (S/D) treated, pooled human plasma indicated for replacement of multiple coagulation factors in patients with acquired deficiencies due to liver disease or who are undergoing cardiac surgery or liver transplantation; and plasma exchange in patients with thrombotic thrombocytopenic purpura (TTP).
Contraindications
Octaplas™ is contraindicated in patients with immunoglobulin A (IgA) deficiency; severe deficiency of protein S; history of hypersensitivity to fresh frozen plasma or to plasma-derived products including any plasma protein; or a history of hypersensitivity reaction to Octaplas™.
Warnings and Precautions
Transfusion reactions can occur with ABO blood group mismatches. Administration of Octaplas™ must be based on ABO-blood group compatibility. High infusion rates can induce hypervolemia with consequent pulmonary edema or cardiac failure. Excessive bleeding due to hyperfibrinolysis can occur due to low levels of alpha2-antiplasmin (also named plasmin inhibitor). Thrombosis can occur due to low levels of Protein S. Citrate toxicity can occur with volumes exceeding one milliliter of Octaplas™ per kg per minute. Octaplas™ is made from human plasma and may carry a risk of transmitting infectious agents, e.g. viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and theoretically, the Creutzfeldt-Jakob disease (CJD) agent.
Adverse Reactions
The most common adverse reactions observed in ≥ 1% of patients included pruritus, urticaria, nausea, headache, paresthesia. Serious adverse reactions seen in clinical trials were anaphylactic shock, citrate toxicity and severe hypotension.
About the Octapharma Group
Headquartered in Lachen, Switzerland, Octapharma is one of the largest human protein products manufacturers in the world and has been committed to patient care and medical innovation since 1983. Its core business is the development and production of human proteins from human plasma and human cell lines. Octapharma employs more than 10,000 people worldwide to support the treatment of patients in over 115 countries with products across the following therapeutic areas: Hematology (coagulation disorders), Immunotherapy (immune disorders) and Critical Care. The company’s American subsidiary, Octapharma USA, is located in Paramus, N.J. Octapharma operates three state-of-the-art production sites licensed by the U.S. Food and Drug Administration (FDA), providing a high level of production flexibility. For more information, please visit octapharmausa.com.
REFERENCES
1 - Red Cross Declares First-ever Blood Crisis amid Omicron Surge, January 11, 2022.
2 - The College of American Pathologists. The coronavirus emergency and the US blood supply: College of American Pathologists Transfusion, Apheresis and Cellular Therapy Committee. March 27, 2020.
3 - Melissa Cushing, M.D. is a paid consultant for Octapharma.
4 - Jan Hartmann J, Klein HG. Supply and demand for plasma-derived medicinal products - A critical reassessment amid the COVID-19 pandemic. Transfusion. 2020;60:2748–2752.
