1. Ticlopidine-, Clopidogrel-, and Prasugrel- Associated Thrombotic Thrombocytopenic Purpura: A 20-Year Review from the Southern Network on Adverse Reactions (SONAR).
- Author
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Jacob, Sony, Dunn, Brianne L., Qureshi, Zaina P., Bandarenko, Nicholas, Kwaan, Hau C., Pandey, Dilip K., McKoy, June M., Barnato, Sara E., Winters, Jeffrey L., Cursio, John F., Weiss, Ivy, Raife, Thomas J., Carey, Patricia M., Sarode, Ravindra, Kiss, Joseph E., Danielson, Constance, Ortel, Thomas L., Clark, William F., Rock, Gail, and Matsumoto, Masanori
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TICLOPIDINE , *CLOPIDOGREL , *PRASUGREL , *THROMBOPENIC purpura , *THROMBOSIS , *ANTICOAGULANTS - Abstract
Thienopyridine-derivatives (ticlopidine, clopidogrel, and prasugrel) are the primary antiplatelet agents. Thrombotic thrombocytopenic purpura (TTP) is a rare drug-associated syndrome, with the thienopyridines being the most common drugs implicated in this syndrome. We reviewed 20 years of information on clinical, epidemiologic, and laboratory findings for thienopyridine-associated TTP. Four, 11, and 11 cases of thienopyridine-associated TTP were reported in the first year ofmarketing of ticlopidine (1989), clopidogrel (1998), and prasugrel (2010), respectively. As of 2011, the FDA received reports of 97 ticlopidine-, 197 clopidogrel-, and 14 prasugrel-associated TTP cases. Severe deficiency of ADAMTS-13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) was present in 80% and antibodies to 100% of these TTP patients on ticlopidine, 0% of the patients with clopidogrelassociated TTP (p < 0.05), and an unknown percentage of patients with prasugrel-associated TTP. TTP is associated with use of each of the three thienopyridines, although the mechanistic pathways may differ. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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