Severe Thrombocytopenia Due to Intravenous Tirofiban Therapy

Patti, Ravikaran; Sinha, Ankur; Rodríguez, Daniel; Khanijao, Suchit; Topi, Bernard; Somal, Navjot

doi:10.1097/mjt.0000000000000756

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…GPIIb/IIIa inhibitors, including abciximab, eptifibatide, and tirofiban, are known to be associated with immune-mediated mechanisms of thrombocytopenia. 4,13 Currently, case reports have indicated that eptifibatide, 48,49 and tirofiban, [50][51][52] could cause acute thrombocytopenia. A metaanalysis has shown an increased risk of bleeding and thrombocytopenia in patients treated with abciximab, compared with the control group.…”

Section: Discussionmentioning

confidence: 99%

An Updated Comprehensive Pharmacovigilance Study of Drug‐Induced Thrombocytopenia Based on FDA Adverse Event Reporting System Data

Kunyu,

Shuping,

Chang

et al. 2024

The Journal of Clinical Pharma

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Drug‐induced Thrombocytopenia (DIT) deserved both clinical and research attention for the serious clinical consequences and high proportion.The current study aimed to perform a comprehensive pharmacovigilance analysis of DIT reported in the FDA Adverse Event Reporting System (FAERS) database, with a particular focus on drugs associated with Thrombocytopenia events. A disproportionality analysis of DIT was conducted using reports submitted to the FARES from January 2004 to December 2022. The algorithms of Information Component (IC) and Reporting Odds Ratio (ROR) were applied to identify the association between target drugs and DIT events. A total of 15,940,383 cases were gathered in FAERS, 168,657 of which were related to DIT event cases. The top 50 drugs by case number and by signal strength were documented. The top five drugs by case number were lenalidomide (10601 cases), niraparib (3726 cases), ruxolitinib (3624 cases), eltrombopag (3483 cases) and heparin (3478 cases). The top five drugs by signal strength were danaparoid (ROR = 37.61, 95% CI 30.46‐46.45), eptifibatide (ROR = 34.75, 95% CI 30.65‐39.4), inotersen (ROR = 34.00, 95% CI 29.47‐39.23), niraparib (ROR = 30.53, 95% CI 29.42‐31.69) and heparin (ROR = 28.84, 95% CI 27.76‐29.97). The top 3 involved drug groups were Protein kinase inhibitors, Antimetabolites, and Monoclonal antibodies and antibody‐drug conjugates. The current comprehensive pharmacovigilance study identified more drugs associated with thrombocytopenia. While some drugs had been elucidated the mechanisms of DIT, others still required further investigation.This article is protected by copyright. All rights reserved

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Section: Discussionmentioning

confidence: 99%

An Updated Comprehensive Pharmacovigilance Study of Drug‐Induced Thrombocytopenia Based on FDA Adverse Event Reporting System Data

Kunyu,

Shuping,

Chang

et al. 2024

The Journal of Clinical Pharma

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“…2 Several cases have reported that thrombocytopenia occurred 12 hours or later after tirofiban therapy. 3–5 We describe a case of extremely rapid and profound thrombocytopenia within 1 hour after small doses of tirofiban.…”

mentioning

confidence: 99%

“…Extremely few profound thrombocytopenia cases (<20 × 10 9 /L) have been described. 3–5 The adverse event typically occurs within the first 24 hours of treatment. Antibodies recognize the neoepitope-induced binding site expressed by GPIIb/IIIa, whose conformation is altered after binding to tirofiban, causing platelet destruction in the affected patients.…”

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confidence: 99%