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Acute thrombocytopenia after treatment with tirofiban or eptifibatide is associated with antibodies specific for ligand-occupied GPIIb/IIIa.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Bougie, Daniel W. Wilker, Peter R. Wuitschick, Elizabeth Curtis, Brian R. Malik, Mohammad Levine, Stewart J. Lind, Richard Pereira, Jaime Aster, Richard H. |
| Copyright Year | 2002 |
| Abstract | Acute thrombocytopenia is a recognized complication of treatment with GPIIb/IIIa inhibitors whose cause is not yet known. We studied 9 patients who developed severe thrombocytopenia (platelets less than 25 x 10(9)/L) within several hours of treatment with the GPIIb/IIIa inhibitors tirofiban (4 patients) and eptifibatide (5 patients). In each patient, acute-phase serum contained a high titer (range, 1:80-1:20 000) IgG antibody that reacted with the glycoprotein IIb/IIIa complex only in the presence of the drug used in treatment. Four patients had been previously treated with the same drug, but 5 had no known prior exposure. Pretreatment serum samples from 2 of the latter patients contained drug-dependent antibodies similar to those identified after treatment. No tirofiban- or eptifibatide-dependent antibodies were found in any of 100 randomly selected healthy blood donors, and only 2 of 23 patients receiving tirofiban or eptifibatide who did not experience significant thrombocytopenia had extremely weak (titer, 1:2) tirofiban-dependent antibodies. In preliminary studies, evidence was obtained that the 9 antibodies recognize multiple target epitopes on GPIIb/IIIa complexed with the inhibitor to which the patient was sensitive, indicating that they cannot all be specific for the drug-binding site. The findings indicate that acute thrombocytopenia after the administration of tirofiban or eptifibatide can be caused by drug-dependent antibodies that are "naturally occurring" or are induced by prior exposure to drug. These antibodies may be human analogs of mouse monoclonal antibodies that recognize ligand-induced binding sites (LIBS) induced in the GPIIb/IIIa heterodimer when it reacts with a ligand-mimetic drug. |
| File Format | PDF HTM / HTML |
| DOI | 10.1182/blood.v100.6.2071 |
| PubMed reference number | 12200368 |
| Journal | Medline |
| Volume Number | 100 |
| Issue Number | 6 |
| Alternate Webpage(s) | http://www.bloodjournal.org/content/bloodjournal/100/6/2071.full.pdf?sso-checked=true |
| Alternate Webpage(s) | https://doi.org/10.1182/blood.v100.6.2071 |
| Journal | Blood |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
