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Vincent L, Bourneau-Martin D, Maurier A, Babin M, Delepine S, Helley D, Grandvuillemin A, Lagarce L, Lillo-Le Louët A, Briet M. Delayed thrombocytopenia following administration of abciximab: Pharmacovigilance survey and literature review. Therapie 2021; 76:687-693. [PMID: 33726948 DOI: 10.1016/j.therap.2021.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 01/15/2021] [Accepted: 02/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Abciximab (ABX) is used for acute coronary syndrome and unstable angina. Thrombocytopenia is a frequent adverse effect described as occurring in the first 24hours. The aim of this study was to evaluate, in a context of pharmacovigilance survey, the occurrence of delayed thrombocytopenia following ABX infusion in pharmacovigilance database reports and in the literature. METHODS Individual case safety reports (ICSRs) of delayed thrombocytopenia-between 3 and 30 days - with ABX presented as a single suspect were selected in VigiBase®, the WHO global database of ICSRs. The French cases were then extracted from the French national pharmacovigilance database. In addition, a literature review of published cases was performed using PubMed. RESULTS Among the 84 ICSRs selected from VigiBase®, 43 were also reported in the FPVD. Mean age was 60.1±12.3 years with a majority of male patients (77.4%). The average time to onset (TTO) was 8.9±5.2 days. Thrombocytopenia regressed in 5.1±2.7 days. Haemorrhagic complications were reported in 15% of ICSRs. In the French cases, the median nadir of platelet count was 28×109/L (range 1-110) with a majority of grade 4 thrombocytopenia (39.5%). The literature review identified 42 cases and provided additional information on administered therapies, which include platelet units, corticosteroids, and IV immunoglobulins. GPIIb/IIIa-ABX complex antibodies were described in 26 published cases. CONCLUSION Delayed thrombocytopenia, probably due to immune reaction, is a possible life-threatening adverse effect of ABX with a mean TTO of 9 days, supporting the recommendation of a platelet count monitoring during at least two weeks. This recommendation was added to the abcximab SmPC in 2019.
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Affiliation(s)
- Louis Vincent
- Department of Pharmacology, Toxicology and Pharmacovigilance, Angers University Hospital, 4, rue Larrey, 49933 Angers, France
| | - Delphine Bourneau-Martin
- Department of Pharmacology, Toxicology and Pharmacovigilance, Angers University Hospital, 4, rue Larrey, 49933 Angers, France.
| | - Anaïs Maurier
- Department of Pharmacology, Toxicology and Pharmacovigilance, Angers University Hospital, 4, rue Larrey, 49933 Angers, France
| | - Marina Babin
- Department of Pharmacology, Toxicology and Pharmacovigilance, Angers University Hospital, 4, rue Larrey, 49933 Angers, France
| | - Stéphane Delepine
- Cardiology Department, Angers University Hospital, 49933 Angers, France
| | - Dominique Helley
- Department of Biological Haematology, George Pompidou European Hospital, 75015 Paris, France
| | | | - Laurence Lagarce
- Department of Pharmacology, Toxicology and Pharmacovigilance, Angers University Hospital, 4, rue Larrey, 49933 Angers, France
| | - Agnès Lillo-Le Louët
- Regional Pharmacovigilance Centre, George Pompidou European Hospital, 75015 Paris, France
| | - Marie Briet
- Department of Pharmacology, Toxicology and Pharmacovigilance, Angers University Hospital, 4, rue Larrey, 49933 Angers, France; University of Angers, 49933 Angers, France; MitoVasc Laboratory, UMR CNRS 6214 Inserm 1083, 49933 Angers, France
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Mahtta D, Bavry AA. αIIbβ3 (GPIIb-IIIa) Antagonists. Platelets 2019. [DOI: 10.1016/b978-0-12-813456-6.00052-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Giupponi L, Cantoni S, Morici N, Sacco A, Giannattasio C, Klugmann S, Savonitto S. Delayed, severe thrombocytemia after abciximab infusion for primary angioplasty in acute coronary syndromes: Moving between systemic bleeding and stent thrombosis. Platelets 2014; 26:498-500. [DOI: 10.3109/09537104.2014.898181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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