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DOI: 10.5482/HAMO-16-07-0026
New treatment options for thrombotic thrombocytopenic purpura
Neue Therapieoptionen bei thrombotisch thrombozytopenischer PurpuraPublication History
received:
19 July 2016
accepted in revised form:
04 November 2016
Publication Date:
28 December 2017 (online)

Summary
The thrombotic-thrombocytopenic purpura (TTP) is an acute, life-threatening disease, characterised by enhanced platelet aggregation, disturbed microcirculation and organ dysfunction. With the currently available treatment (plasma exchange, infusions, corticosteroids) mortality ist still as high as 10–15 %. Recent, pathophysiology-based developments may improve the outcome. The most promising candidates for future treatment of TTP are: rituximab for termination of the autoimmune process, caplacizumab for prevention of platelet-VWF-interaction, and recombinant ADAMTS13 for replacement of the inhibited or missing enzyme.
Zusammenfassung
Die thrombotisch-thrombozytopenische Purpura (TTP) ist eine akute, lebensbedrohliche Erkrankung, bei der durch eine vermehrte Thrombozytenaggregation die Mikrozirkulation und Organfunktion gestört ist. Mit den zur Zeit verfügbaren Behandlungsoptionen (Plasma-Austausch, Plasma-Infusionen, Steroide) liegt die Mortalität immer noch bei 10–15 %. Neuere Pathophysiologie-basierte Entwicklungen könnten die Überlebensrate verbessern. Die vielversprechendsten Kandidaten für die zukünftige Behandlung der TTP sind: Rituximab zur Beendigung des Autoimmunprozesses, Caplazizumab zur Verhinderung der Thrombozyten-VWF-Interaktion und rekombinantes ADAMTS13 zur Zufuhr des blockierten oder fehlenden Enzyms.
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References
- 1 Scully M, Hunt BJ, Benjamin S. et al. Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies. Br J Haematol 2012; 158 (03) 323-335.
- 2 Knöbl P. Inherited and acquired thrombotic thrombocytopenic purpura (TTP) in adults. Semin Thromb Hemost 2014; 40 (04) 493-502.
- 3 Knöbl PN. Treatment of thrombotic microangiopathy with a focus on new treatment options. Hamostaseologie 2013; 33 (02) 149-159.
- 4 Kopic A, Benamara K, Piskernik C. et al. Preclinical assessment of a new recombinant ADAMTS-13 drug product (BAX930) for the treatment of thrombotic thrombocytopenic purpura. J Thromb Haemost 2016; 14 (07) 1410-1419.
- 5 Plaimauer B, Kremer JAHovinga, Juno C. et al. Recombinant ADAMTS13 normalizes von Wille-brand factor-cleaving activity in plasma of acquired TTP patients by overriding inhibitory antibodies. J Thromb Haemost 2011; 09 (05) 936-944.
- 6 Peyvandi F, Scully M, Kremer JAHovinga. et al. Caplacizumab for Acquired Thrombotic Thrombocytopenic Purpura. N Engl J Med 2016; 11; 374 (06) 511-522.
- 7 Cataland SR, Peyvandi F, Mannucci PM. et al. Initial experience from a double-blind, placebo-controlled, clinical outcome study of ARC1779 in patients with thrombotic thrombocytopenic purpura. Am J Hematol 2012; 87 (04) 430-432.