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Hypersensitivity reactions to modern antiplatelet and anticoagulant drugs

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Abstract

Anticoagulation and antiplatelet drugs are among the most commonly used medical drugs. In addition to the long-established heparins, hirudins, coumarins and antiplatelet drugs such as acetylsalicylic acid, numerous novel and predominantly synthetic pharmacologic agents have come onto the market in recent years. These new agents act at various sites in coagulation and have significantly broadened treatment options. Whilst immunological hypersensitivity reactions are on the whole rare, they have a considerable impact on patient management when they do occur. The present overview discusses the currently known hypersensitivity reactions to anticoagulant and antiplatelet agents, with particular attention to the newer substance classes including P2Y12 inhibitors, glycoprotein IIb/IIIb receptor antagonists, direct factor Xa inhibitors and direct thrombin inhibitors.

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Abbreviations

AA:

Arachidonic acid

ADP:

Adenosine diphosphate

ADR:

Adverse drug reaction

AERD:

Aspirin exacerbated respiratory disease

AGEP:

Acute generalized exanthematous pustulosis

ASA:

Acetylsalicylic acid

cAMP:

Cyclic adenosine monophosphate

COOH:

Carboxyl group

CYP:

Cytochrome P450

DILI:

Drug induced liver injury

DRESS:

Drug rash with eosinophilia and systemic systems

EMA:

European Medicines Agency

Fab:

Fragment antigen binding

FDA:

US Food and Drug Administration

GP:

Glycoprotein

HACA:

Human antichimeric antibodies

HAMA:

Human anti-murine antibodies

HIT:

Heparin-induced thrombocytopenia

HLA:

Human leukocyte antigen

HMWH:

High molecular weight heparin (unfractionated heparin)

Ig:

Immunoglobulin

LMWH:

Low molecular weight heparin

LT:

Leukotriene

NSAID:

Nonsteroidal anti-inflammatory drugs

PDE:

Phosphodiesterase

PG:

Prostaglandin

P2Y12:

Adenosine receptor

SCAR:

Severe cutaneous adverse reaction

TEN:

Toxic epidermal necrolysis

TIA:

Transient ischemic attack

T-R:

Thromboxane receptor

TxA2:

Thromboxane A2

WHO:

World Health Organization

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Authors and Affiliations

  1. Allergy Unit, Department of Dermatology, University Hospital, Basel, Switzerland

    Kathrin Scherer Hofmeier & Andreas J. Bircher

  2. Allergy Unit Department of Dermatology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland

    Kathrin Scherer Hofmeier

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  1. Kathrin Scherer Hofmeier
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  2. Andreas J. Bircher
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Correspondence to Kathrin Scherer Hofmeier.

Additional information

Cite this as Scherer Hofmeier K, Bircher AJ. Hypersensitivity reactions to modern antiplatelet and anticoagulant drugs. Allergo J Int 2015; 24:58–66 DOI: 10.1007/s40629-015-0043-7

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Hofmeier, K.S., Bircher, A.J. Hypersensitivity reactions to modern antiplatelet and anticoagulant drugs. Allergo J Int 24, 58–66 (2015). https://doi.org/10.1007/s40629-015-0048-2

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