Objectives The purpose of this analysis was to evaluate the use of recombinant human antithrombin (rhAT) in preventing venous thromboembolism (VTE) in pregnant patients with hereditary AT deficiency (HATD). Study Design Data from two clinical trials were pooled. Dosing of rhAT was based on body weight and baseline AT activity, started up to 24 hours before scheduled induction or cesarean delivery, or at the onset of labor. Results A total of 21 pregnant HATD patients were enrolled. Mean rhAT therapy duration was 4.3 days and dose was 245.1 IU/kg/day. All patients achieved target mean AT activity (80-120% of normal) during rhAT therapy. There were no confirmed VTEs during rhAT treatment or within 7 (±1) days after dosing. Two VTE events (one deep vein thrombosis and one pulmonary embolism) occurred 11 and 14 days after discontinuation of rhAT, in patients managed with prophylactic doses of heparin or low-molecular-weight heparin following delivery. Conclusion rhAT was safe and effective in pregnant HATD patients when administered during the peripartum period, the period of highest VTE risk and a time when anticoagulation therapy is normally withheld. Pregnant HATD patients may benefit from therapeutic, rather than prophylactic, doses of anticoagulation after delivery to protect against postpartum VTE.

Paidas, M., Triche, E., James, A., Desancho, M., Robinson, C., Lazarchick, J., et al. (2016). Recombinant Human Antithrombin in Pregnant Patients with Hereditary Antithrombin Deficiency: Integrated Analysis of Clinical Data. AMERICAN JOURNAL OF PERINATOLOGY, 33(4), 343-349 [10.1055/s-0035-1564423].

Recombinant Human Antithrombin in Pregnant Patients with Hereditary Antithrombin Deficiency: Integrated Analysis of Clinical Data

ORNAGHI, SARA
Penultimo
;
2016

Abstract

Objectives The purpose of this analysis was to evaluate the use of recombinant human antithrombin (rhAT) in preventing venous thromboembolism (VTE) in pregnant patients with hereditary AT deficiency (HATD). Study Design Data from two clinical trials were pooled. Dosing of rhAT was based on body weight and baseline AT activity, started up to 24 hours before scheduled induction or cesarean delivery, or at the onset of labor. Results A total of 21 pregnant HATD patients were enrolled. Mean rhAT therapy duration was 4.3 days and dose was 245.1 IU/kg/day. All patients achieved target mean AT activity (80-120% of normal) during rhAT therapy. There were no confirmed VTEs during rhAT treatment or within 7 (±1) days after dosing. Two VTE events (one deep vein thrombosis and one pulmonary embolism) occurred 11 and 14 days after discontinuation of rhAT, in patients managed with prophylactic doses of heparin or low-molecular-weight heparin following delivery. Conclusion rhAT was safe and effective in pregnant HATD patients when administered during the peripartum period, the period of highest VTE risk and a time when anticoagulation therapy is normally withheld. Pregnant HATD patients may benefit from therapeutic, rather than prophylactic, doses of anticoagulation after delivery to protect against postpartum VTE.
Articolo in rivista - Articolo scientifico
antithrombin deficiency; pregnancy; recombinant human antithrombin; venous thromboembolism;
antithrombin deficiency; pregnancy; recombinant human antithrombin; venous thromboembolism; Adult; Anticoagulants; Antithrombin III; Antithrombin III Deficiency; Female; Heparin, Low-Molecular-Weight; Humans; Internationality; Peripartum Period; Pregnancy; Recombinant Proteins; Venous Thrombosis; Young Adult; Pediatrics, Perinatology and Child Health; Obstetrics and Gynecology
English
2016
33
4
343
349
none
Paidas, M., Triche, E., James, A., Desancho, M., Robinson, C., Lazarchick, J., et al. (2016). Recombinant Human Antithrombin in Pregnant Patients with Hereditary Antithrombin Deficiency: Integrated Analysis of Clinical Data. AMERICAN JOURNAL OF PERINATOLOGY, 33(4), 343-349 [10.1055/s-0035-1564423].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/157364
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