Thursday May 22, 2008
Plavix (Clopidogrel) associated TTP

An important reminder regarding Plavix.

Clopidogrel (Plavix) is used commonly in patients with cerebrovascular and coronary disease as an antiplatelet drug. Now there are substantial number of cases reported in literature of thrombotic thrombocytopenic purpura (TTP) associated with use of Clopidogrel (Plavix).

Clopidogrel-associated TTP often occurs within 2 weeks of drug initiation and has a high mortality if not treated promptly.

Key is prompt diagnosis as the survival rate for clopidogrel-associated TTP is almost 100% if therapeutic plasma exchange performed within 3 days of onset of TTP (100% vs 27.3%).



References: Click to get abstract if available

1. Clopidogrel-Associated TTP - Stroke. 2004;35:533

2. Clopidogrel and thrombotic thrombocytopenic purpura: No clear case for causality - CLEVELAND CLINIC JOURNAL OF MEDICINE , VOLUME 70 • NUMBER 5, MAY 2003 -pdf file

3. Thrombotic thrombocytopenic purpura associated with clopidogrel administration: case report and brief review. Am J Med Sci 2001; 322:170–172.

4. Plasmapheresis improves survival in drug-induced thrombotic thrombocytopenic purpura: systematic review of published case reports [abstract]. Blood 2001; 98(Suppl 1):60b.

5. Thrombotic thrombocytopenic purpura occurring after exposure to clopidogrel [abstract]. Blood 1999; 94(Suppl 1):78b.

6. Clopidogrel-associated TTP [abstract]. Transfusion 1999; 39(Suppl):56S.

7. Clopidogrel and thrombotic thrombocytopenic purpura. N Engl J Med 2000; 343:1193–1194.