Evidence map›Paper›PMID 39830971›Full record

ArticleResearch and practice in thrombosis and haemostasis2025

Characterization of bleeding in thrombotic thrombocytopenic purpura in the precaplacizumab era: a retrospective nationwide analysis.

Amir A Mahmoud, Mariam Mostafa, Ali Abdelhay, Mouhamed Yazan Abou-Ismail, Shruti Chaturvedi

Abstract read
In one paragraph

Article in Research and practice in thrombosis and haemostasis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Amir A MahmoudDivision of Hematology, Department of Medicine, Washington University School of Medicine in St. Louis, Missouri, USA.
Mariam MostafaDepartment of Internal Medicine, Rochester General Hospital, Rochester, New York, USA.
Ali AbdelhayDepartment of Internal Medicine, Rochester General Hospital, Rochester, New York, USA.
Mouhamed Yazan Abou-IsmailDivision of Hematology and Hematologic Malignancies, Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
Shruti ChaturvediDivision of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Funding

Targeting silent cerebral infarction to improve long-term neurologic outcomes in immune thrombotic thrombocytopenic purpura (iTTP)R00HL172303 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Shruti Chaturvedi · 2024 to 2026
$1.3M
NHLBI NIH HHS R00 HL172303
6 · The paper itself

Abstract

Background: The addition of caplacizumab to immune thrombotic thrombocytopenia (iTTP) treatment options has led to a renewed interest in characterizing the epidemiology and risk factors for bleeding in iTTP. Limited data exist on the bleeding risk in iTTP due to systemic underreporting in earlier cohorts. Objectives: To describe the incidence, patterns, and predictors of bleeding in hospitalized iTTP patients independent of caplacizumab use. Methods: We retrospectively analyzed the National Inpatient Sample database (2012-2019) and identified adult patients with a diagnosis of iTTP. Predictors of bleeding were determined by multivariable logistic regression analysis. Results: We identified 3103 iTTP hospitalizations; bleeding occurred in 594 (19.1%), and 157 (5.1%) were characterized by major bleeding. Mucocutaneous bleeding (7.6%) was the most frequent type of bleeding and included heavy menstrual bleeding (2.6%), gingival (2.3%), epistaxis (1.4%), and skin/procedure-related bleeding (1.3%). This was followed closely by gastrointestinal bleeding (5.6%). Patients with bleeding were more likely to be Hispanic, have a weekend admission, and have a higher prevalence of comorbidities. In the multivariable analysis, Hispanic race (odds ratio [OR], 1.48; 1.14-1.91), Asian/Pacific Islander/Native American race (OR, 2.04; 1.51-2.76), coronary artery disease (OR, 1.70; 1.38-2.11), heart failure (OR, 1.39; 1.13-1.72), autoimmune disease (OR, 2.61; 2.08-3.26), Charlson Comorbidity Index ≥ 3 (OR, 2.08; 1.66-2.61), weekend admission (OR, 1.45; 1.22-1.72), and delay ≥2 days in plasma exchange initiation (OR, 1.63; 1.38-1.92), were significantly associated with major bleeding. Conclusions: Bleeding is a relatively common issue in acute iTTP that has not been adequately addressed in existing literature. Further studies are needed to elucidate this risk and associated factors, especially given the incorporation of caplacizumab in the treatment of iTTP.

Indexed as

bleedingcaplacizumabNational Inpatient Sampleplasma exchangethrombotic thrombocytopenic purpura

Identifiers

PMID39830971
PMCPMC11742298

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