Benefit Profile of Thrombomodulin Alfa Combined with Antithrombin Concentrate in Patients with Sepsis-Induced Disseminated Intravascular Coagulation

Clinical and Applied Thrombosis/Hemostasis

卷:28

Original Manuscript

Atsushi Murao ; Takayuki Kato ; Tetsunobu Yamane ; Goichi Honda ; Yutaka Eguchi

[1] Department of Critical and Intensive Care Medicine, , Seta, Tsukinowa-cho, Otsu, Shiga, Japan

[2] Medical Affairs Division, , Yurakucho, Chiyoda-ku, Tokyo, Japan

[3] Division of Emergency and Intensive Care Unit, , Otsu, Shiga, Japan

关键词: disseminated intravascular coagulation;    thrombocytopenia;    anticoagulants;    antithrombins;    thrombomodulin;    infections;   

DOI  :  10.1177/10760296221077096

 received in 2021-10-18, accepted in 2022-01-12,  发布年份 2022

来源: Sage Journals

【 摘 要 】

Thrombomodulin alfa (TM-α, recombinant human soluble thrombomodulin) and antithrombin (AT) concentrate are anticoagulant agents for the treatment of disseminated intravascular coagulation (DIC). A post hoc analysis using data from 1198 patients with infection-induced DIC from the post-marketing surveillance of TM-α was conducted. To identify subgroups that benefit from combination therapy, the patients were a priori stratified into four groups by a platelet (Plt) count of 50 × 103/μL and plasma AT level of 50% (groups 1, 2, 3, and 4, with high Plt/high AT, high Plt/low AT, low Plt/high AT, and low Plt/low AT, respectively). Kaplan-Meier survival analysis showed significantly worse survival in groups 2 and 4 had than in group 1 (p = 0.0480, p < 0.0001, respectively), and multivariate analysis showed that concomitant AT concentrate was independently correlated with reduced 28-day mortality only in group 4 (hazard ratio 0.6193; 95% confidence interval, 0.3912-0.9805). The adverse drug reactions (ADRs) and bleeding ADRs were not different among the groups. Patients with both severe thrombocytopenia and AT deficiency are candidates for combined anticoagulant therapy with TM-α and AT concentrate.

【 授权许可】

CC BY-NC   
© The Author(s) 2022

【 图 表 】

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