Acute thrombocytopenia after treatment with tirofiban or eptifibatide is associated with antibodies specific for ligand-occupied GPIIb/IIIa

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dc.contributor.authorBougie, DW
dc.contributor.authorWilker, PR
dc.contributor.authorWuitschick, ED
dc.contributor.authorCurtis, BR
dc.contributor.authorMalik, M
dc.contributor.authorLevine, S
dc.contributor.authorLind, RN
dc.contributor.authorPereira, J
dc.contributor.authorAster, RH
dc.date.accessioned2025-01-21T01:10:32Z
dc.date.available2025-01-21T01:10:32Z
dc.date.issued2002
dc.description.abstractAcute 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.
dc.description.funderNHLBI NIH HHS
dc.fuente.origenWOS
dc.identifier.eissn1528-0020
dc.identifier.issn0006-4971
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/96695
dc.identifier.wosidWOS:000177884800019
dc.issue.numero6
dc.language.isoen
dc.pagina.final2076
dc.pagina.inicio2071
dc.revistaBlood
dc.rightsacceso restringido
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAcute thrombocytopenia after treatment with tirofiban or eptifibatide is associated with antibodies specific for ligand-occupied GPIIb/IIIa
dc.typeartículo
dc.volumen100
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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