Combined use of antifibrinolytics and activated prothrombin complex concentrate (aPCC) is not related to thromboembolic events in patients with acquired haemophilia A: data from FAIR Registry

Sergio Siragusa, Mariasanta Napolitano, Gaetano Giuffrida, Samantha Pasca, Mameli, Mariasanta Napolitano, Federici, Sergio Siragusa, Cantori, Ambaglio, Rocino, Cristina Santoro, Ezio Zanon, Falanga, Rita Santoro, Lodigiani, Corrado Santoro

Risultato della ricerca: Article

Abstract

Antifibrinolytics combined with aPCC are not routinely administered to patients with acquired hemophilia A due to increased thrombotic risk. This association normalizes clot stability, and improves the efficacy of therapy, but can increase the risk of severe side effects. Due to these premises it has always raised doubts and perplexities in the clinics. We now report the data of the “FEIBA® on acquired haemophilia A Italian Registry (FAIR Registry)”, a retrospective-prospective study that included 56 patients. This is the first study that assessed the clinical response of the combination of aPCC and antifibrinolytic agents in patients with acquired haemophilia A. A total of 101 acute bleeds were treated with aPCC. Antifibrinolytic agents were used in the treatment of 39.6% of total bleeds, based on both, a clinical assessment and an evaluation of bleeding. Twenty-five of the 30 patients (57.1%) treated with antifibrinolytic drugs showed serious co-morbidity. Among them, 40% presented severe cardiovascular diseases. All bleeds treated with combined therapy had a shorter duration of treatment (mean reduction 16.3%). All the treated patients presented a good tolerability and no arterial or venous thromboembolic events were reported. In our retrospective registry the combination of antifibrinolytics and aPCC appears safe and effective in the treatment of patients with AHA, especially in the case of severe and life-threatening bleeding, but this hypothesis needs to be confirmed in adequate, larger clinical trials.
Lingua originaleEnglish
pagine (da-a)129-133
Numero di pagine5
RivistaJournal of Thrombosis and Thrombolysis
Volume47
Stato di pubblicazionePublished - 2019

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Antifibrinolytic Agents
Registries
Hemorrhage
Therapeutics
prothrombin complex concentrates
Acquired Factor 8 deficiency
Cardiovascular Diseases
Retrospective Studies
Clinical Trials
Prospective Studies
Morbidity
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Hematology
  • Cardiology and Cardiovascular Medicine

Cita questo

Combined use of antifibrinolytics and activated prothrombin complex concentrate (aPCC) is not related to thromboembolic events in patients with acquired haemophilia A: data from FAIR Registry. / Siragusa, Sergio; Napolitano, Mariasanta; Giuffrida, Gaetano; Pasca, Samantha; Mameli; Napolitano, Mariasanta; Federici; Siragusa, Sergio; Cantori; Ambaglio; Rocino; Santoro, Cristina; Zanon, Ezio; Falanga; Santoro, Rita; Lodigiani; Santoro, Corrado.

In: Journal of Thrombosis and Thrombolysis, Vol. 47, 2019, pag. 129-133.

Risultato della ricerca: Article

Siragusa, S, Napolitano, M, Giuffrida, G, Pasca, S, Mameli, Napolitano, M, Federici, Siragusa, S, Cantori, Ambaglio, Rocino, Santoro, C, Zanon, E, Falanga, Santoro, R, Lodigiani & Santoro, C 2019, 'Combined use of antifibrinolytics and activated prothrombin complex concentrate (aPCC) is not related to thromboembolic events in patients with acquired haemophilia A: data from FAIR Registry', Journal of Thrombosis and Thrombolysis, vol. 47, pagg. 129-133.
Siragusa, Sergio ; Napolitano, Mariasanta ; Giuffrida, Gaetano ; Pasca, Samantha ; Mameli ; Napolitano, Mariasanta ; Federici ; Siragusa, Sergio ; Cantori ; Ambaglio ; Rocino ; Santoro, Cristina ; Zanon, Ezio ; Falanga ; Santoro, Rita ; Lodigiani ; Santoro, Corrado. / Combined use of antifibrinolytics and activated prothrombin complex concentrate (aPCC) is not related to thromboembolic events in patients with acquired haemophilia A: data from FAIR Registry. In: Journal of Thrombosis and Thrombolysis. 2019 ; Vol. 47. pagg. 129-133.
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title = "Combined use of antifibrinolytics and activated prothrombin complex concentrate (aPCC) is not related to thromboembolic events in patients with acquired haemophilia A: data from FAIR Registry",
abstract = "Antifibrinolytics combined with aPCC are not routinely administered to patients with acquired hemophilia A due to increased thrombotic risk. This association normalizes clot stability, and improves the efficacy of therapy, but can increase the risk of severe side effects. Due to these premises it has always raised doubts and perplexities in the clinics. We now report the data of the “FEIBA{\circledR} on acquired haemophilia A Italian Registry (FAIR Registry)”, a retrospective-prospective study that included 56 patients. This is the first study that assessed the clinical response of the combination of aPCC and antifibrinolytic agents in patients with acquired haemophilia A. A total of 101 acute bleeds were treated with aPCC. Antifibrinolytic agents were used in the treatment of 39.6{\%} of total bleeds, based on both, a clinical assessment and an evaluation of bleeding. Twenty-five of the 30 patients (57.1{\%}) treated with antifibrinolytic drugs showed serious co-morbidity. Among them, 40{\%} presented severe cardiovascular diseases. All bleeds treated with combined therapy had a shorter duration of treatment (mean reduction 16.3{\%}). All the treated patients presented a good tolerability and no arterial or venous thromboembolic events were reported. In our retrospective registry the combination of antifibrinolytics and aPCC appears safe and effective in the treatment of patients with AHA, especially in the case of severe and life-threatening bleeding, but this hypothesis needs to be confirmed in adequate, larger clinical trials.",
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author = "Sergio Siragusa and Mariasanta Napolitano and Gaetano Giuffrida and Samantha Pasca and Mameli and Mariasanta Napolitano and Federici and Sergio Siragusa and Cantori and Ambaglio and Rocino and Cristina Santoro and Ezio Zanon and Falanga and Rita Santoro and Lodigiani and Corrado Santoro",
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T1 - Combined use of antifibrinolytics and activated prothrombin complex concentrate (aPCC) is not related to thromboembolic events in patients with acquired haemophilia A: data from FAIR Registry

AU - Siragusa, Sergio

AU - Napolitano, Mariasanta

AU - Giuffrida, Gaetano

AU - Pasca, Samantha

AU - Mameli, null

AU - Napolitano, Mariasanta

AU - Federici, null

AU - Siragusa, Sergio

AU - Cantori, null

AU - Ambaglio, null

AU - Rocino, null

AU - Santoro, Cristina

AU - Zanon, Ezio

AU - Falanga, null

AU - Santoro, Rita

AU - Lodigiani, null

AU - Santoro, Corrado

PY - 2019

Y1 - 2019

N2 - Antifibrinolytics combined with aPCC are not routinely administered to patients with acquired hemophilia A due to increased thrombotic risk. This association normalizes clot stability, and improves the efficacy of therapy, but can increase the risk of severe side effects. Due to these premises it has always raised doubts and perplexities in the clinics. We now report the data of the “FEIBA® on acquired haemophilia A Italian Registry (FAIR Registry)”, a retrospective-prospective study that included 56 patients. This is the first study that assessed the clinical response of the combination of aPCC and antifibrinolytic agents in patients with acquired haemophilia A. A total of 101 acute bleeds were treated with aPCC. Antifibrinolytic agents were used in the treatment of 39.6% of total bleeds, based on both, a clinical assessment and an evaluation of bleeding. Twenty-five of the 30 patients (57.1%) treated with antifibrinolytic drugs showed serious co-morbidity. Among them, 40% presented severe cardiovascular diseases. All bleeds treated with combined therapy had a shorter duration of treatment (mean reduction 16.3%). All the treated patients presented a good tolerability and no arterial or venous thromboembolic events were reported. In our retrospective registry the combination of antifibrinolytics and aPCC appears safe and effective in the treatment of patients with AHA, especially in the case of severe and life-threatening bleeding, but this hypothesis needs to be confirmed in adequate, larger clinical trials.

AB - Antifibrinolytics combined with aPCC are not routinely administered to patients with acquired hemophilia A due to increased thrombotic risk. This association normalizes clot stability, and improves the efficacy of therapy, but can increase the risk of severe side effects. Due to these premises it has always raised doubts and perplexities in the clinics. We now report the data of the “FEIBA® on acquired haemophilia A Italian Registry (FAIR Registry)”, a retrospective-prospective study that included 56 patients. This is the first study that assessed the clinical response of the combination of aPCC and antifibrinolytic agents in patients with acquired haemophilia A. A total of 101 acute bleeds were treated with aPCC. Antifibrinolytic agents were used in the treatment of 39.6% of total bleeds, based on both, a clinical assessment and an evaluation of bleeding. Twenty-five of the 30 patients (57.1%) treated with antifibrinolytic drugs showed serious co-morbidity. Among them, 40% presented severe cardiovascular diseases. All bleeds treated with combined therapy had a shorter duration of treatment (mean reduction 16.3%). All the treated patients presented a good tolerability and no arterial or venous thromboembolic events were reported. In our retrospective registry the combination of antifibrinolytics and aPCC appears safe and effective in the treatment of patients with AHA, especially in the case of severe and life-threatening bleeding, but this hypothesis needs to be confirmed in adequate, larger clinical trials.

KW - Acquired haemophilia A

KW - Activated prothrombin complex concentrate

KW - Antifibrinolytics

KW - Cardiology and Cardiovascular Medicine

KW - Hematology

KW - Thromboembolic risk

UR - http://hdl.handle.net/10447/305550

UR - http://www.wkap.nl/journalhome.htm/0929-5305

M3 - Article

VL - 47

SP - 129

EP - 133

JO - Journal of Thrombosis and Thrombolysis

JF - Journal of Thrombosis and Thrombolysis

SN - 0929-5305

ER -