Clopidogrel Desensitization

Lee-Wong, Mary; Gadhvi, Deval; Resnick, David

doi:10.1016/s1081-1206(10)61080-0

Cited by 15 publications

(18 citation statements)

References 10 publications

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“…The clopidogrel solubilization technique differed among inpatients; however, this would have been unlikely to significantly affect the solutions' concentrations or absorption rates. Previous publications speculate as to the cause of clopidogrel sensitivity (10,16,17), but until the mechanism is found, the terms "allergy" and "hypersensitivity" should not be used as these relate only to immunoglobulin E-mediated reactions. Interestingly, all of our study participants reacted to clopidogrel on their first continuous exposures to the drug.…”

Section: Discussionmentioning

confidence: 99%

Clopidogrel Desensitization After Drug-Eluting Stent Placement

Tiehl

Price

Valencia

et al. 2007

Journal of the American College of Cardiology

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Section: Discussionmentioning

confidence: 99%

Clopidogrel Desensitization After Drug-Eluting Stent Placement

Tiehl

Price

Valencia

et al. 2007

Journal of the American College of Cardiology

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“…The three patients were maintained on clopidogrel for at least 6 months, with one patient being maintained for at least 3 years. This protocol has been utilized in another separate case report and case series with success [24,25]. A different protocol has been described in a case series of eight patients who were desensitized in 2 h (Table 2) [19].…”

Section: Desensitizationmentioning

confidence: 99%

Management Strategies for Clopidogrel Hypersensitivity

Beavers

Carris

Ruf

2015

Drugs

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Clopidogrel is a cornerstone of dual antiplatelet therapy. Hypersensitivity reactions potentially limit the use of this treatment and present a significant clinical challenge. The authors have developed recommendations for the management of clopidogrel hypersensitivity with consideration for the etiology, pathophysiology, and critical evaluation of potential management strategies. The clopidogrel hypersensitivity reaction is complex in mechanism and presents generally around day 5 of treatment. Generalized reactions are most common, but the reaction may also be localized or systemic. Screening patients for hypersensitivity is not always possible because the type IV delayed reaction is not detected reliably by conventional skin prick, intradermal challenge, or patch testing. Proposed strategies for management of clopidogrel hypersensitivity include treatment of the reaction with corticosteroids, clopidogrel desensitization, substituting an alternative P2Y12 inhibitor, or clopidogrel avoidance. The safety, efficacy, and cost of each potential strategy must be considered when managing a patient with clopidogrel hypersensitivity.

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“…Two of the three patients in this case-series had experienced hypersensitivity with both clopidogrel and ticlopidine, necessitating desensitization. Following this same protocol, Lee-Wong was able to reproduce their success with clopidogrel desensitization on an additional patient [49]. All subsequent desensitization protocols have been modifications derived from the protocols described by Vigo or Camara and Almeda.…”

Section: Clopidogrel Desensitizationmentioning

confidence: 99%