Safety of antithrombotic therapy in subjects with hereditary hemorrhagic telangiectasia: prospective data from a multidisciplinary working group

Eleonora Gaetani, Antonio Gasbarrini, Roberto Pola, Giulio Cesare Passali, Maria Elena Riccioni, Alfredo Puca, Carmine Di Stasi, Pietro Manuel Ferraro, Emanuela Lucci Cordisco, Giuseppe Zampino, Veronica Ojetti, Gaetano Antonio Lanza, Erica De Candia, Fabiana Agostini, Igor Giarretta, Daniela Feliciani, Luigi Di Martino, Annalisa Tortora, Carmelo Lucio Sturiale, Andrea ContegiacomoValentina Giorgio, Elisabetta Peppucci, Luigi Corina, Angelo Porfidia, L Riccardi, Ciello AE Del, AF Cavaliere, G Marrone, G Spoletini, G Locorotondo, MT. Lombardi

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

3 Citazioni (Scopus)

Abstract

Subjects with the rare autosomal dominant disease Hereditary Hemorrhagic Telangiectasia (HHT) may develop medical conditions that require antithrombotic therapy (AT). However, safety of AT is uncertain in these patients and the only data currently available derive from retrospective analyses of registries and/or databases. At the HHT Centre of the ‘Fondazione Policlinico Universitario A. Gemelli IRCCS’ (Rome, Italy), a prospective study is currently ongoing to evaluate the safety of AT in subjects affected by HHT. The study is enrolling subjects with a definite diagnosis of HHT who receive an AT prescription by one of the physicians of the HHT Centre. The primary outcome is the number of hemorrhagic events, distinguished in major, clinically relevant non-major (CRNM), and minor bleedings, according to the criteria of the International Society on Thrombosis and Hemostasis (ISTH). Another primary outcome is worsening of epistaxis upon initiation of AT, assessed using the internationally accepted Epistaxis Severity Score (ESS). Additional outcomes are changes in hemoglobin levels and changes in the need of blood transfusion after initiation of AT. Here, we present the results of an interim analysis, conducted on the 12 HHT subjects that have been enrolled so far. After a mean follow-up of 6.5 ± 0.8 months, no major bleedings, no CRNM bleedings, and no minor bleedings different from epistaxis were recorded. Worsening of epistaxis upon initiation of AT was documented only in one patient, but did not require discontinuation of AT. There were no significant changes in the mean ESS measured before and after initiation of AT. There were no significant changes in hemoglobin levels and need for blood transfusion after initiation of AT. Although preliminary, these are the first prospective data on the safety of AT in HHT patients. Our interim analysis suggests that, when prescribed by experienced physicians in a multidisciplinary setting, AT is well tolerated by HHT patients. More patients and a longer follow-up are needed to confirm these findings
Lingua originaleEnglish
pagine (da-a)298-N/A
RivistaOrphanet Journal of Rare Diseases
Volume14
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Hereditary Hemorrhagic Teleangectasia, antithrombotic therapy

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