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

AI Article Synopsis

  • Thrombomodulin alfa (TM-α) and antithrombin (AT) concentrate are anticoagulants used to treat disseminated intravascular coagulation (DIC) caused by infections.
  • A study analyzed data from 1,198 DIC patients and identified four subgroups based on their platelet count and AT levels, focusing on those most likely to benefit from combination therapy.
  • Results showed that only patients with both low platelet counts and low AT levels (group 4) had a significant reduction in 28-day mortality when treated with both TM-α and AT concentrate, indicating they are prime candidates for this combination therapy.

Article Abstract

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 × 10/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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8851499PMC
http://dx.doi.org/10.1177/10760296221077096DOI Listing

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