Identifying drugs that cause acute thrombocytopenia: an analysis using 3 distinct methods

Blood. 2010 Sep 23;116(12):2127-33. doi: 10.1182/blood-2010-03-276691. Epub 2010 Jun 8.

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adverse Drug Reaction Reporting Systems
  • Antibodies / blood
  • Blood Platelets / immunology
  • Data Mining
  • Drug-Related Side Effects and Adverse Reactions*
  • Humans
  • Methods
  • Pharmaceutical Preparations / blood
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / diagnosis*
  • Thrombocytopenia / immunology
  • United States
  • United States Food and Drug Administration

Substances

  • Antibodies
  • Pharmaceutical Preparations