Advocate Lutheran General Hospital, Park Ridge, IL, USA.
Rosalind Franklin University, North Chicago, IL, USA.
Ann Pharmacother. 2021 Dec;55(12):1467-1473. doi: 10.1177/10600280211006645. Epub 2021 Apr 3.
Eptifibatide is used in acute coronary syndromes to reversibly block platelet aggregation by inhibiting the platelet glycoprotein IIb/IIIa receptor. A serious adverse effect of eptifibatide is a profound drop in platelet count, termed eptifibatide-induced thrombocytopenia (EIT).
To provide insight into the types of complications and management of EIT.
Cases of EIT submitted to the Food and Drug Administration adverse event reporting system were evaluated. Data analyses included management of EIT, complications of thrombocytopenia, initial platelets, and platelet nadir following eptifibatide.
103 cases of EIT were reported from January 2010 to 2019; 57 cases met the Naranjo scale and were included. Only 37 of those cases contained information on how EIT was managed. Eptifibatide administration was withheld in all 37 of those cases. Platelet transfusions were administered in 20 cases (54%). Two cases were managed with steroids (5.4%), and 1 case used intravenous immunoglobulin G to reverse EIT (2%). The median initial platelet count prior to administration of eptifibatide was 207 000 cells/mm (SD = 69 000; n = 27), and median platelet nadir was 9000 cells/mm (SD = 19 000; n = 35) The majority of complications of EIT included bleeding events (16/28, 57%). Delayed procedures, prolonged stay, allergic reactions, and thrombosis were each reported in 3 patients (10.75%).
Most cases of EIT were managed by withholding eptifibatide with platelet transfusion if necessary. The majority of complications included bleeding. However, significant procedure delays, prolonged hospital stay, thrombosis, and allergic reactions were also reported.
依替巴肽用于治疗急性冠脉综合征，通过抑制血小板糖蛋白 IIb/IIIa 受体来可逆地阻止血小板聚集。依替巴肽的一个严重不良反应是血小板计数明显下降，称为依替巴肽诱导的血小板减少症（EIT）。
深入了解 EIT 的并发症类型和管理方法。
评估了提交给美国食品和药物管理局不良事件报告系统的 EIT 病例。数据分析包括 EIT 的管理、血小板减少症的并发症、初始血小板计数和依替巴肽后血小板计数最低值。
2010 年 1 月至 2019 年报告了 103 例 EIT 病例；57 例符合 Naranjo 量表标准并被纳入。这些病例中只有 37 例包含有关如何管理 EIT 的信息。在这 37 例中，所有病例均停止了依替巴肽的使用。20 例（54%）给予血小板输注。2 例使用类固醇（5.4%）治疗，1 例使用静脉注射免疫球蛋白 G 逆转 EIT（2%）。依替巴肽使用前的中位初始血小板计数为 207000 个/立方毫米（标准差=69000；n=27），中位数血小板计数最低值为 9000 个/立方毫米（标准差=19000；n=35）。EIT 的大多数并发症包括出血事件（16/28，57%）。延迟手术、延长住院时间、过敏反应和血栓形成各有 3 例（10.75%）报告。
大多数 EIT 病例通过停用依替巴肽并在必要时给予血小板输注来治疗。大多数并发症包括出血。然而，也报告了显著的手术延迟、延长的住院时间、血栓形成和过敏反应。
