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Does Caplacizumab for the management of thrombotic thrombocytopenic purpura increase the risk of relapse, exacerbation, and bleeding? An updated systematic review and meta-analysis based on revised criteria by the International Working Group for thrombotic thrombocytopenic purpura.
Neupane, Niraj; Thapa, Sangharsha; Mahmoud, Amir; Bhattarai, Abhinav; Kc, Anil; Shikhrakar, Shreeja; Gurusinghe, Sayuri; Kuiodes, Peter.
Afiliação
  • Neupane N; Rochester General Hospital Department of Internal Medicine Rochester New York USA.
  • Thapa S; Kathmandu University School of Medical Sciences Dhulikhel Nepal.
  • Mahmoud A; Rochester General Hospital Department of Internal Medicine Rochester New York USA.
  • Bhattarai A; Institute of Medicine, Maharjgunj Medical Campus Kathmandu Nepal.
  • Kc A; Patan Academy of Health Sciences Patan Nepal.
  • Shikhrakar S; Patan Academy of Health Sciences Patan Nepal.
  • Gurusinghe S; University of Buffalo Department of Internal Medicine Buffalo New York USA.
  • Kuiodes P; Lipson Cancer Center, Rochester General Hospital Department of Hematology New York USA.
EJHaem ; 5(1): 178-190, 2024 Feb.
Article em En | MEDLINE | ID: mdl-38406548
ABSTRACT
Thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening condition marked by abnormal blood clotting and organ damage. Caplacizumab is a potential treatment for the TTP management. This systematic review and meta-analysis aimed to assess Caplacizumab's effectiveness and safety in the TTP management. A comprehensive database search identified nine studies, including randomized controlled trials and observational studies. Primary outcomes included TTP exacerbation, relapse, and major bleeding. Major bleeding risk was evaluated using updated definitions recommended by the International TTP Working Group in 2021. Revised criteria proposed by the IWG for TTP recurrence were employed for a comprehensive assessment of Caplacizumab's impact on relapse and exacerbation. Analysis revealed Caplacizumab significantly reduced all-cause mortality in TTP patients. Some studies raised concerns about bleeding risk, but overall, it did not significantly differ from standard treatment. Likewise, there was no significant difference in TTP relapse rates between Caplacizumab and standard care. This study supports Caplacizumab as a potential adjunct therapy for TTP. However, careful consideration of its advantages and risks is crucial in clinical practice. Further research is needed to address concerns related to adverse effects like bleeding risk and relapse rates associated with Caplacizumab in the TTP management. The findings emphasize the importance of weighing potential benefits and risks when considering Caplacizumab as an adjunct therapy for TTP.

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: EJHaem Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: EJHaem Ano de publicação: 2024 Tipo de documento: Article