Epsilon-Aminocaproic Acid (EACA)

Griffin, James D.; Ellman, Leonard

doi:10.1055/s-0028-1087143

Cited by 54 publications

(22 citation statements)

References 70 publications

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“…No patient had to discontinue therapy because of side effects. Since the incidence of complications reportedly increases with dose above 24 g/d, we did not exceed this dose in this study (3). From this preliminary study we conclude that EACA is safe and tolerable in this clinical setting.…”

Section: Discussionmentioning

confidence: 87%

Anti‐fibrinolytic therapy with aminocaproic acid for the control of bleeding in thrombocytopenic patients

Garewal

Durie

1985

Scandinavian Journal of Haematology

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11 courses of EACA were given to 9 acutely ill, severely thrombocytopenic patients (platelet count < 20 x IOy/l). 6 patients were being treated for acute leukaemia while I each had cyclical amegakaryocytic thrombocytopenia, dysmyelopoietic syndrome and advanced chronic lymphocytic leukaemia. 8 were refractory to HLA-matched platelets and 1 refused blood product transfusion. All had simultaneous major medical complications such as infection and granulocytopenia. The highest dose of EACA used was 24 mg/d. Improvement in haemostasis was noted in all patients with successful control of epistaxis in 1, control of gastrointestinal bleeding in 3 and lack of significant bleeding for 4-29 d in the remaining 5 patients. The only toxicity was doserelated nausea. Since this patient group was at extremely high risk for haemorrhage, we conclude that EACA is safe and useful in the management of thrombocytopenia including that occurring during leukaemic induction.

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Section: Discussionmentioning

confidence: 87%

Anti‐fibrinolytic therapy with aminocaproic acid for the control of bleeding in thrombocytopenic patients

Garewal

Durie

1985

Scandinavian Journal of Haematology

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“…Epsilon-aminocaproic acid (EACA) was also infused after G-PBC transplant until human BDDFVIII reached a significant level in platelets. EACA is an effective synthetic inhibitor of the plasmin–plasminogen system and controls subarachnoid haemorrhage, genitourinary bleeding from many causes and dental surgery in haemophiliacs30. For comparison, the number of serious bleeding episodes that required treatment with cFVIII supplement has been recorded 1 year before and 2.5 years after G-PBC transplant for each dog (Table 1, columns 10, 11)31.…”

Section: Resultsmentioning

confidence: 99%

Platelet-targeted gene therapy with human factor VIII establishes haemostasis in dogs with haemophilia A

et al. 2013

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It is essential to improve therapies for controlling excessive bleeding in patients with haemorrhagic disorders. As activated blood platelets mediate the primary response to vascular injury, we hypothesize that storage of coagulation Factor VIII within platelets may provide a locally inducible treatment to maintain haemostasis for haemophilia A. Here we show that haematopoietic stem cell gene therapy can prevent the occurrence of severe bleeding episodes in dogs with haemophilia A for at least 2.5 years after transplantation. We employ a clinically relevant strategy based on a lentiviral vector encoding the ITGA2B gene promoter, which drives platelet-specific expression of human FVIII permitting storage and release of FVIII from activated platelets. One animal receives a hybrid molecule of FVIII fused to the von Willebrand Factor propeptide-D2 domain that traffics FVIII more effectively into α-granules. The absence of inhibitory antibodies to platelet-derived FVIII indicates that this approach may have benefit in patients who reject FVIII replacement therapies. Thus, platelet FVIII may provide effective long-term control of bleeding in patients with haemophilia A.

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“…The use of EACA is contraindicated in the case of: thrombotic diseases of veins and arteries, artheriosclerosis with a thrombus tendency, renal diseases, blood escape into body cavities and internal organs, pathological states with a accumulation of fibrin as pneumonia, a pregnancy until the end of first trimester, a period of mother' s milk feeding, haematuria, ureters clogging by thrombus, a decrease to 1/3 twentyfour hours volume of urine, creatinine clearance lower than 80-50 ml/min (3,14,33,34).…”

Section: Contraindications Interactions Undesirable Effectsmentioning

confidence: 99%

“…EACA is used in: bleedings owing to an activation of fibrinolytic system and a overdose of t-PA or streptokinase; systemic diseases bleedings: congenital haemorrhagic diathesis, thrombocytopenia, leukaemia, aplastic anaemia; surgical procedures: after heart-vascular operations, prostatectomy, lungs and liver operations and in the surgical wound bleedings; bleedings associated with internal disease: cirrhosis of the liver, oesophageal varices, chronic gastric ulcer disease; non-surgical bleedings, for example parenchymatous bleedings; obstetric-gynaecological problems: an excessive menstrual bleeding, after abortion, an excessive bleeding after plancetal detachment, in uterine myoma; stomatology and laryngology: prophylactic oral treatment 1 h before a tooth or tonsils extraction in the case of patients with haemophilia and locally (as tampons) after a tooth extraction or epistaxis (3,14,15,16).…”

Section: Therapeutic Indications Pharmacokinecitsmentioning

confidence: 99%