Clopidogrel desensitization protocol for the treatment of thienopyridine hypersensitivity.
The antiplatelet agent clopidogrel has become a mainstay of treatment of patients with acute coronary syndromes and strokes, and to reduce ischemic complications after percutaneous coronary and peripheral interventions. As the use of this agent has become more widespread, hypersensitivity reactions to clopidogrel have been increasingly recognized. This problem can be difficult to manage, especially in patients who are in need of or have recently undergone intracoronary stenting, as therapeutic alternatives are limited. Our previously published experience shows that desensitization can allow clopidogrel to be used safely in these patients. The protocol is simple, rapid, and can be conducted by a team of cardiology and allergy-immunology specialists. This article outlines the procedural details of the protocol.
Department of Internal Medicine, Division of Cardiovascular Diseases, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA.
Nicholas E
NE
Walker
Mary B
MB
Fasano
Ryan A
RA
Hobbs
Phillip A
PA
Horwitz
D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary; D002985:Clinical Protocols; D000077144:Clopidogrel; D003888:Desensitization, Immunologic / Q000379:methods*; D004342:Drug Hypersensitivity / Q000209:etiology / Q000517:prevention & control*; D005076:Exanthema / Q000139:chemically induced; D006801:Humans; D018579:Patient Selection; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology; D015607:Stents; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000276:immunology
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine