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Identifying drugs that cause acute thrombocytopenia: an analysis using 3 distinct methods. Blood 2010 Sep 23;116(12):2127-33

Date

06/10/2010

Pubmed ID

20530792

Pubmed Central ID

PMC2951857

DOI

10.1182/blood-2010-03-276691

Scopus ID

2-s2.0-77957192740 (requires institutional sign-in at Scopus site)   121 Citations

Abstract

Drug-induced immune thrombocytopenia (DITP) is often suspected in patients with acute thrombocytopenia unexplained by other causes, but documenting that a drug is the cause of thrombocytopenia can be challenging. To provide a resource for diagnosis of DITP and for drug safety surveillance, we analyzed 3 distinct methods for identifying drugs that may cause thrombocytopenia. (1) Published case reports of DITP have described 253 drugs suspected of causing thrombocytopenia; using defined clinical criteria, 87 (34%) were identified with evidence that the drug caused thrombocytopenia. (2) Serum samples from patients with suspected DITP were tested for 202 drugs; drug-dependent, platelet-reactive antibodies were identified for 67 drugs (33%). (3) The Food and Drug Administration's Adverse Event Reporting System database was searched for drugs associated with thrombocytopenia by use of data mining algorithms; 1444 drugs had at least 1 report associated with thrombocytopenia, and 573 (40%) drugs demonstrated a statistically distinctive reporting association with thrombocytopenia. Among 1468 drugs suspected of causing thrombocytopenia, 102 were evaluated by all 3 methods, and 23 of these 102 drugs had evidence for an association with thrombocytopenia by all 3 methods. Multiple methods, each with a distinct perspective, can contribute to the identification of drugs that can cause thrombocytopenia.

Author List

Reese JA, Li X, Hauben M, Aster RH, Bougie DW, Curtis BR, George JN, Vesely SK

Author

Brian Curtis PhD Director in the Platelet & Neutrophil Immunology Laboratory department at BloodCenter of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adverse Drug Reaction Reporting Systems
Antibodies
Blood Platelets
Data Mining
Drug-Related Side Effects and Adverse Reactions
Humans
Methods
Pharmaceutical Preparations
Thrombocytopenia
United States
United States Food and Drug Administration