Evidence map›Paper›PMID 27558507›Full record

Trial reportArthritis research & therapy2016

Reduced induction of anti-PF4/heparin antibody in RA patients after total knee arthroplasty.

Masahiro Izumi, Tatsuya Sakai, Atsunori Shirakawa, Hideko Kozuru, Yuka Jiuchi, Yasumori Izumi, Tomohiko Asahara, Kenji Kumagai, Masaaki Mawatari, Makoto Osaki and 2 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Arthritis research & therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Masahiro IzumiDepartment of Molecular Immunology, Unit of Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8501, Japan.
Tatsuya SakaiDepartment of Molecular Immunology, Unit of Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8501, Japan.
Atsunori ShirakawaDepartment of Pharmacy, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.
Hideko KozuruDepartment of Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.
Yuka JiuchiDepartment of Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.
Yasumori IzumiDepartment of Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.
Tomohiko AsaharaDepartment of Orthopedic Surgery, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.
Kenji KumagaiDepartment of Orthopedic Surgery, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.
Masaaki MawatariDepartment of Orthopedic Surgery, Saga University Hospital, Nabeshima 5-1-1, Saga, 849-8501, Japan.
Makoto OsakiDepartment of Orthopedic Surgery, Nagasaki University Hospital, Sakamoto 1-7-1, Nagasaki, 852-8501, Japan.
Satoru MotokawaSuga Orthopedic Hospital, Ono 332, Isahaya, 854-0034, Japan.
Kiyoshi MigitaDepartment of Rheumatology, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan. migita@fmu.ac.jp.
Nagasaki Medical Center · JPNagasaki University · JPNagasaki University Hospital · JPSaga University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHeparin-induced thrombocytopenia is caused by antibodies (Abs) specific to platelet factor 4 (PF4)/heparin complexes. In this study, we evaluated the rates of seroconversion of anti-PF4/heparin Ab between patients with rheumatoid arthritis (RA) and with osteoarthritis (OA) who underwent total knee arthroplasty.

methodsThe subjects of this randomized controlled trial were 124 patients who underwent total knee arthroplasty (TKA) and received edoxaban with or without a foot pump as thromboprophylaxis. We measured anti-PF4/heparin Abs before and 10 days after surgery, as well as preoperative PF4, using commercially available ELISAs. We also used the database of J-PSVT, a hospital-based, prospective cohort study designed to document the effectiveness of thromboprophylactic agents during arthroplasty.

resultsThe rates of seroconversion to anti-PF4/heparin Ab were lower in RA patients (4.0 %) than in OA patients (25.5 %). The anti-PF4/heparin IgG optical density (OD) values did not differ before and after surgery in RA patients. In contrast, there was a significant increase in anti-PF4/heparin IgG OD values in OA patients after TKA. In the J-PSVT data, the postoperative seroconversion rates of anti-PF4/heparin Ab were lower in RA patients (10.4 %) than in OA patients (21.8 %) who received fondaparinux. The titers of anti-CCP Ab were significantly lower in RA patients with postoperative ant-PF4/heparin Ab compared with those without postoperative ant-PF4/heparin Ab There was no significant difference in preoperative PF4 levels between RA patients and OA patients. The heparin-binding affinity of the circulating PF4 was similar between RA patients and OA patients; however, the IgG fractions isolated from the sera of RA patients contained PF4 more frequently (69.2 %) than those from OA patients (10.2 %).

conclusionsOur results showed a reduced likelihood of postoperative anti-PF/heparin Ab production in RA patients compared with OA patients. This suggests that the mechanisms underlying the anti-PF4 immune response in RA patients differ from the mechanisms of the anti-PF4/heparin immune response seen in OA patients after joint replacement.

trial registrationISRCTN 18090286. Registered 8 July 2016.

Indexed as

AgedArthritis, RheumatoidArthroplasty, Replacement, KneeAutoantibodiesAutoantigensEnzyme-Linked Immunosorbent AssayFactor Xa InhibitorsFemaleHumansImmunoblottingImmunoglobulin GMaleMiddle AgedOsteoarthritisPlatelet Factor 4PyridinesAutoantibodiesAutoantigensedoxabanFactor Xa InhibitorsImmunoglobulin GPlatelet Factor 4PyridinesThiazolesAnti-PF4/heparin antibodiesHeparin-induced thrombocytopeniaOsteoarthritisPlatelet factor 4Rheumatoid arthritisTotal knee arthroplasty

Identifiers

PMID27558507
PMCPMC4997690
OpenAlexW2518294858

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.