Evidence map›Paper›PMID 40834870›Full record

ArticleThrombosis and haemostasis2026

High Anti-ADAMTS13 IgG Levels after Plasma Exchange Predict Delayed ADAMTS13 Normalization in Immune-Mediated Thrombotic Thrombocytopenic Purpura.

Marienn Réti, Andreea-Adela Icleanu, Andrea Várkonyi, Ágnes Király, Luca Bogsch, Zita Farkas, Péter Reményi, Zoltán Prohászka, György Sinkovits

Abstract read
In one paragraph

Article in Thrombosis and haemostasis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

9 authors.

Marienn RétiDepartment of Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest - Institute of Hematology and Infectious Diseases, Budapest, Hungary.
Andreea-Adela IcleanuDepartment of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary.ORCID 0009-0002-0576-5363
Andrea VárkonyiDepartment of Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest - Institute of Hematology and Infectious Diseases, Budapest, Hungary.
Ágnes KirályDepartment of Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest - Institute of Hematology and Infectious Diseases, Budapest, Hungary.
Luca BogschDepartment of Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest - Institute of Hematology and Infectious Diseases, Budapest, Hungary.
Zita FarkasDepartment of Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest - Institute of Hematology and Infectious Diseases, Budapest, Hungary.
Péter ReményiDepartment of Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest - Institute of Hematology and Infectious Diseases, Budapest, Hungary.
Zoltán ProhászkaDepartment of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary.
György SinkovitsDepartment of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary.ORCID 0000-0002-5355-7318

Funding

Emberi Eroforrások Minisztériuma TKP2021-EGA-24HORIZON EUROPE 2021 Research and Innovation 101072729
6 · The paper itself

Abstract

Background: In acute immune-mediated TTP (iTTP) caplacizumab therapy has proved to be effective in achieving an early clinical response. However, the discontinuation of caplacizumab therapy before ADAMTS13 activity has at least partially recovered can potentially lead to disease recurrence. Of note, normalization of ADAMTS13 activity was reported to be delayed in caplacizumab-treated patients. Aims: To investigate delayed ADAMTS13 normalization and its potential causes. Patients/Methods: We conducted a retrospective detailed longitudinal investigation of ADAMTS13 activity and anti-ADAMTS13 IgG levels in a single-center cohort of caplacizumab-treated iTTP patients ( Results: We observed that ADAMTS13 activity was lower in caplacizumab-treated patients than in historical controls 1 week after therapeutic plasma exchange (TPE) was discontinued upon first clinical response (post-TPE). The difference later gradually decreased and we observed no delay in attaining ADAMTS13 activity thresholds of 20% (partial ADAMTS13 remission, reached in median 26 vs. 25 days after the first TPE session) or higher. However, almost half of the caplacizumab-treated patients needed more than 30 days to achieve partial ADAMTS13 remission. Importantly, we found that the post-TPE anti-ADAMTS13 IgG level correlates with the time until partial ADAMTS13 remission both in caplacizumab-treated and historical control patients, and is a significant predictor of delayed ADAMTS13 normalization. Conclusion: The latter finding has important clinical implications, as it suggests that measuring post-TPE anti-ADAMTS13 IgG levels may help identify patients who need additional immunosuppressive treatment to avoid delayed ADAMTS13 normalization.

Indexed as

ADAMTS13 ProteinAutoantibodiesImmunoglobulin GPlasma ExchangePurpura, Thrombotic ThrombocytopenicAdultAgedFemaleHumansImmunosuppressive AgentsLongitudinal StudiesMaleMiddle AgedPredictive Value of TestsRecurrenceRetrospective StudiesADAMTS13 ProteinADAMTS13 protein, humanAutoantibodiescaplacizumabImmunoglobulin GImmunosuppressive AgentsSingle-Domain Antibodies

Identifiers

PMID40834870
PMCPMC13288346

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.