Evidence map›Paper›PMID 31891657›Full record

ArticleBlood advances2020

A modern reassessment of glycoprotein-specific direct platelet autoantibody testing in immune thrombocytopenia.

Hanny Al-Samkari, Rachel P Rosovsky, Rebecca S Karp Leaf, David B Smith, Katayoon Goodarzi, Annemarie E Fogerty, David B Sykes, David J Kuter

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Blood advances, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 2 pooled it
5.9field-weighted citation impact, top 3% 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

37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.

  1. Guideline
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  4. Article
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  6. Article
  7. Review
  8. ITP in pregnancy: diagnostics and therapeutics in 2024.Hematology. American Society of Hematology. Education Program · 2024
    Review
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  11. Article
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  13. Article
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  16. Article
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  18. Novel Biomarkers for Diagnosis and Monitoring of Immune Thrombocytopenia.International journal of molecular sciences · 2023
    Review
  19. Review
  20. How we treat primary immune thrombocytopenia in adults.Journal of hematology & oncology · 2023
    Review
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

8 authors at 1 institution in 1 country.

Hanny Al-SamkariDivision of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Rachel P RosovskyDivision of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Rebecca S Karp LeafDivision of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
David B SmithDivision of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Katayoon GoodarziDivision of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Annemarie E FogertyDivision of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
David B SykesDivision of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
David J KuterDivision of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Harvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Platelet autoantibody (PA) testing has previously shown poor sensitivity for immune thrombocytopenia (ITP) diagnosis, but no previous study used both 2011 American Society of Hematology (ASH) guidelines for ITP diagnosis and 2012 International Society on Thrombosis and Haemostasis (ISTH) PA testing recommendations. We therefore performed a comprehensive retrospective study of PA testing in adult patients with ITP strictly applying these criteria. Of 986 PA assays performed, 485 assays in 368 patients met criteria and were included. Sensitivity and specificity of a positive test result for diagnosis of active ITP (n = 228 patients) were 90% and 78%, respectively. Sensitivity and specificity of a negative test result for clinical remission (n = 61 assays) were 87% and 91%. Antibodies against both glycoprotein IIb (GPIIb)/IIIa and GPIb/IX were required for the presence of antibodies against GPIa/IIa in patients with ITP. Logistic regression analysis revealed that more positive autoantibodies predicted more severe disease (relative to nonsevere ITP, relative risk ratio for severe ITP and refractory ITP was 2.27 [P < .001] and 3.09 [P < .001], respectively, per additional autoantibody); however, serologic testing did not meaningfully predict treatment response to glucocorticoids, intravenous immunoglobulin, or thrombopoietin receptor agonists. Sixty-four patients with ITP had multiple PA assays performed longitudinally: all 10 patients achieving remission converted from positive to negative serologic results, and evidence for epitope spreading was observed in 35% of patients with ongoing active disease. In conclusion, glycoprotein-specific direct PA testing performed using ISTH recommendations in patients meeting ASH diagnostic criteria is sensitive and specific for ITP diagnosis and reliably confirms clinical remission. More glycoproteins targeted by autoantibodies predicts for more severe disease.

Indexed as

Purpura, Thrombocytopenic, IdiopathicThrombocytopeniaAdultAutoantibodiesHumansPlatelet Glycoprotein GPIb-IX ComplexRetrospective StudiesAutoantibodiesPlatelet Glycoprotein GPIb-IX Complex

Identifiers

PMID31891657
PMCPMC6960466
OpenAlexW2996903540

What OpenQuestion holds

Textmetadata
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Registered trials

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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.