Novel antiplatelet strategies targeting VWF and GPIb

Autor: Nithya Prasannan, Marie Scully
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Platelets, Vol 32, Iss 1, Pp 42-46 (2021)
Druh dokumentu: article
ISSN: 0953-7104
1369-1635
09537104
DOI: 10.1080/09537104.2020.1786038
Popis: Von Willebrand factor has a pivotal role in primary hemostasis. Its role in thrombotic microangiopathies (TMA), as well as cardiovascular disease, has been demonstrated. Thrombotic thrombocytopenic purpura (TTP), a thrombotic microangiopathy, is a life-threatening condition with a high mortality rate if untreated. Current management strategies comprise plasma exchange to remove autoantibodies and replenish ADAMTS13, along with immunosuppressive agents in immune TTP. This review focuses on novel antiplatelet strategies that target VWF and GPIb. The benefits of the nanobody caplacizumab in achieving faster normalization of platelet count, as well as reduced thromboembolic events were shown through TITAN and HERCULES trials, and these findings have been practice changing. The use of caplacizumab in patients with immune TTP (iTTP) has now become well established. Potential benefits of ARC1779 and N-acetylcysteine have also been shown on a small scale in iTTP, however these lack evidence through larger randomized controlled trials. Further therapies, some in early phase, others in clinical practice, target platelet aggregation within arteries and their utility is presented with cerebrovascular disorders.
Databáze: Directory of Open Access Journals
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