Document Detail

Ticlopidine-, clopidogrel-, and prasugrel-associated thrombotic thrombocytopenic purpura: a 20-year review from the Southern Network on Adverse Reactions (SONAR).
MedLine Citation:
PMID:  23111862     Owner:  NLM     Status:  MEDLINE    
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 of marketing 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 clopidogrel-associated 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.
Sony Jacob; Brianne L Dunn; Zaina P Qureshi; Nicholas Bandarenko; Hau C Kwaan; Dilip K Pandey; June M McKoy; Sara E Barnato; Jeffrey L Winters; John F Cursio; Ivy Weiss; Thomas J Raife; Patricia M Carey; Ravindra Sarode; Joseph E Kiss; Constance Danielson; Thomas L Ortel; William F Clark; Gail Rock; Masanori Matsumoto; Yoshihiro Fujimura; X Long Zheng; Hao Chen; Fei Chen; John M Armstrong; Dennis W Raisch; Charles L Bennett
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2012-10-30
Journal Detail:
Title:  Seminars in thrombosis and hemostasis     Volume:  38     ISSN:  1098-9064     ISO Abbreviation:  Semin. Thromb. Hemost.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-06     Completed Date:  2013-06-27     Revised Date:  2014-04-14    
Medline Journal Info:
Nlm Unique ID:  0431155     Medline TA:  Semin Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  845-53     Citation Subset:  IM    
Copyright Information:
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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MeSH Terms
Piperazines / adverse effects
Platelet Aggregation Inhibitors / adverse effects*
Purpura, Thrombotic Thrombocytopenic / chemically induced*
Thienopyridines / adverse effects*
Thiophenes / adverse effects
Ticlopidine / adverse effects,  analogs & derivatives
Grant Support
1K01CA134554-01/CA/NCI NIH HHS; 1R01CA 102713-01/CA/NCI NIH HHS; P01 HL074124/HL/NHLBI NIH HHS; R01 CA102713/CA/NCI NIH HHS; R01 CA165609/CA/NCI NIH HHS; R01 HL079027/HL/NHLBI NIH HHS
Reg. No./Substance:
0/Piperazines; 0/Platelet Aggregation Inhibitors; 0/Thienopyridines; 0/Thiophenes; 34K66TBT99/prasugrel; A74586SNO7/clopidogrel; OM90ZUW7M1/Ticlopidine

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