Identifying drugs that cause acute thrombocytopenia: an analysis using 3 distinct methods.
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.
Reese
Jessica A
JA
Department of Biostatistics and Epidemiology, College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73190, USA.
Li
Xiaoning
X
Hauben
Manfred
M
Aster
Richard H
RH
Bougie
Daniel W
DW
Curtis
Brian R
BR
George
James N
JN
Vesely
Sara K
SK
D016907:Adverse Drug Reaction Reporting Systems; D000906:Antibodies / Q000097:blood; D001792:Blood Platelets / Q000276:immunology; D057225:Data Mining; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D008722:Methods; D004364:Pharmaceutical Preparations / Q000097:blood; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis* / Q000276:immunology; D014481:United States; D014486:United States Food and Drug Administration
D000906:Antibodies; D004364:Pharmaceutical Preparations