Catastrophic antiphospholipid syndrome in an immune thrombocytopenia patient treated with avatrombopag

Vondel, Saartje Van de; Vandenbriele, Christophe; Gheysens, Gerald; Verhamme, Peter; Janssens, Ann

doi:10.1016/j.rpth.2023.100125

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…In a clinical case of CAPS secondary to immune thrombocytopenic purpura (ITP), a 20-year-old patient presented to the emergency department with non-specific manifestation [ 83 ]. In this case, treatment with high doses of corticosteroids and the introduction of IVIG did not lead to significant improvements.…”

Section: Principles Of Treatmentmentioning

confidence: 99%

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Catastrophic Antiphospholipid Syndrome

Bitsadze,

Yakubova,

Khizroeva

et al. 2024

IJMS

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Unlike classic APS, CAPS causes multiple microthrombosis due to an increased inflammatory response, known as a “thrombotic storm”. CAPS typically develops after infection, trauma, or surgery and begins with the following symptoms: fever, thrombocytopenia, muscle weakness, visual and cognitive disturbances, abdominal pain, renal failure, and disseminated intravascular coagulation. Although the presence of antiphospholipid antibodies in the blood is one of the diagnostic criteria, the level of these antibodies can fluctuate significantly, which complicates the diagnostic process and can lead to erroneous interpretation of rapidly developing symptoms. Triple therapy is often used to treat CAPS, which includes the use of anticoagulants, plasmapheresis, and high doses of glucocorticosteroids and, in some cases, additional intravenous immunoglobulins. The use of LMWH is recommended as the drug of choice due to its anti-inflammatory and anticoagulant properties. CAPS is a multifactorial disease that requires not only an interdisciplinary approach but also highly qualified medical care, adequate and timely diagnosis, and appropriate prevention in the context of relapse or occurrence of the disease. Improved new clinical protocols and education of medical personnel regarding CAPS can significantly improve the therapeutic approach and reduce mortality rates.

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Section: Principles Of Treatmentmentioning

confidence: 99%

“…Based on the pathophysiological mechanisms of CAPS development, the use of immunosuppressive drugs is the most reasonable choice [ 83 ]. Immunosuppression reduces antibody production, normalizing other B cell functions.…”

Section: Principles Of Treatmentmentioning

confidence: 99%

Catastrophic Antiphospholipid Syndrome

Bitsadze,

Yakubova,

Khizroeva

et al. 2024

IJMS

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Avatrombopag

2023

Reactions Weekly

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Data mining and safety analysis of avatrombopag: a retrospective pharmacovigilance study based on the US food and drug administration’s adverse event reporting system

Zhu,

2024

Sci Rep

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With its increasing use in the treatment of thrombocytopenia, avatrombopag’s associated adverse events (AEs) pose a major challenge to its clinical application. This study aims to comprehensively study AEs associated with avatrombopag by using real-world evidence. We curated AE reports for avatrombopag from the first quarter of 2018 to the fourth quarter of 2023 in the US Food and Drug Administration’s Adverse Event Reporting System (FAERS) database. AEs were coded using the Medical Dictionary for Regulatory Activities of Preferred Terms and System Organ Classes. The reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network, and multi-item Gamma-Poisson Shrinker were used to investigate the relationship between avatrombopag and AE reports. Among 9,060,312 reported cases in the FAERS database, 1211 reports listed avatrombopag as “primary suspected” drug. Disproportionality analysis identified 44 preferred terms across 17 organ systems met the criteria for at least one of the four algorithms. The most commonly reported AEs were platelet count decreased (20.2%), headache (16.7%), platelet count increased (11.9%), platelet count abnormal (6.3%), contusion (2.7%), pulmonary embolism (2.3%), and deep vein thrombosis (2.1%). Unexpected AEs such as seasonal allergy, rhinorrhea, antiphospholipid syndrome, ear discomfort, and photopsia were also observed. Excluding the other serious outcomes, hospitalization (34.6%) was the most frequently reported serious outcome, followed by death (15.4%). Most reported AEs occurred within the first 2 days of initiating avatrombopag therapy, and the median onset time was 60 days. We identified new and unexpected AEs with clinical use of avatrombopag, and our results may provide valuable information for clinical monitoring and identifying risks associated with avatrombopag.

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Catastrophic antiphospholipid syndrome in an immune thrombocytopenia patient treated with avatrombopag

Cited by 3 publications

References 19 publications

Catastrophic Antiphospholipid Syndrome

Catastrophic Antiphospholipid Syndrome

Avatrombopag

Data mining and safety analysis of avatrombopag: a retrospective pharmacovigilance study based on the US food and drug administration’s adverse event reporting system

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