Safety of antithrombotic therapy in subjects with hereditary hemorrhagic telangiectasia: prospective data from a multidi
- PDF / 318,608 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 39 Downloads / 210 Views
(2019) 14:298
LETTER TO THE EDITOR
Open Access
Safety of antithrombotic therapy in subjects with hereditary hemorrhagic telangiectasia: prospective data from a multidisciplinary working group Eleonora Gaetani1,2,3, Fabiana Agostini1,4, Angelo Porfidia1,4, Igor Giarretta1,3, Daniela Feliciani1,4, Luigi Di Martino1, Annalisa Tortora1, Antonio Gasbarrini1,2,3, Roberto Pola1,3,4* and on behalf of the Multidisciplinary Gemelli Group for HHT 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. Dear Editor, We read with interest the studies published by Shovlin and colleagues [1] and by Riera-Mestre and colleagues [2] in two recent issues of the Orphanet Journal of Rare Diseases. Both studies dealt with the issue of thrombotic * Correspondence: [email protected] 1 Multidisciplinary Gemelli Group for HHT, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy 3 Department of Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168 Rome, Italy
Data Loading...
