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Thromb Haemost 2002; 88(06): 892-897
DOI: 10.1055/s-0037-1613330
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Schattauer GmbH

Acute Thrombocytopenia in Patients Treated with the Oral Glycoprotein IIb/IIIa Inhibitors Xemilofiban and Orbofiban: Evidence for an Immune Etiology

Jacqueline A. Brassard
3   Pharmacia Corporation, St. Louis MO
,
Brian R. Curtis
1   The Blood Research Institute, Blood Center of Wisconsin, Milwaukee, WI
,
Richard A. Cooper
2   Medical College of Wisconsin, Milwaukee, WI
,
John Ferguson
3   Pharmacia Corporation, St. Louis MO
,
Wendy Komocsar
3   Pharmacia Corporation, St. Louis MO
,
Maria Ehardt
1   The Blood Research Institute, Blood Center of Wisconsin, Milwaukee, WI
,
Stuart Kupfer
3   Pharmacia Corporation, St. Louis MO
,
Clement Maurath
3   Pharmacia Corporation, St. Louis MO
,
Edward Swabb
3   Pharmacia Corporation, St. Louis MO
,
Christopher P. Cannon
4   The Brigham and Women’s Hospital, Boston Massachusetts, U.S.A.
,
Richard H. Aster
1   The Blood Research Institute, Blood Center of Wisconsin, Milwaukee, WI
2   Medical College of Wisconsin, Milwaukee, WI
› Author AffiliationsSupported by grants HL-13629 and HL-44612 from the National Heart, Lung, and Blood Institute.
Further Information

Publication History

Received 20 May 2002

Accepted after resubmission 13 August 2002

Publication Date:
09 December 2017 (online)

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Summary

Thrombocytopenic episodes occurring in 18,845 patients treated with the GPIIb/IIIa inhibitors xemilofiban and orbofiban (“fibans”) were analyzed by a blinded review panel and 73 patients were classified as having “possible fiban-induced thrombocytopenia”. When the treatment codes were broken, a significant association between drug exposure and assignment to this group was found (p <0.001). Twenty-eight (82%) of 34 archived serum samples from these patients contained fiban-dependent antibodies specific for GPIIb/IIIa, but no such antibodies were found in 61 drug treated patients not classified as having “possible fiban-induced thrombocytopenia” (p <0.001). We conclude that fiban-dependent antibodies were the major cause of acute, severe thrombocytopenia in patients judged on the basis of clinical findings to have thrombocytopenia “possibly-induced” by xemilofiban and orbofiban. Measurement of drug-dependent antibodies may be helpful in determining the basis for acute thrombocytopenia in fiban-treated patients and possibly for identification of patients at risk to develop thrombocytopenia.

Keywords

Platelets - GPIIb/IIIa inhibitors - antibodies
 

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