Clinical Drug Investigation

, Volume 19, Issue 3, pp 231–237

Adverse Haematological Effects of Ticlopidine

A Report of Four Cases
  • Massimo Gallerani
  • R. Manfredini
  • P. Donegà
  • F. Lanza
  • M. Da Busti
  • G. B. Vigna
  • R. Fellin
Case Reports

References

  1. 1.
    Sharis PJ, Cannon CP, Loscalzo J. The antiplatelet effects of ticlopidine and clopidogrel. Ann Intern Med 1998; 129: 394–405PubMedGoogle Scholar
  2. 2.
    Harbison JW. Ticlopidine versus aspirin for the prevention of recurrent stroke. Analysis of patients with minor stroke from the ticlopidine aspirin stroke study. Stroke 1992; 23: 1723–7PubMedCrossRefGoogle Scholar
  3. 3.
    Davis SM, Donnan GA. Secondary prevention for stroke after CAPRIE and ESRS-2. Opinion 1. Cerebrovasc Dis 1998; 8: 73–5PubMedCrossRefGoogle Scholar
  4. 4.
    Diener HC. Antiplatelet drugs in secondary prevention of stroke. Int J Clin Pract 1998; 52: 91–7PubMedGoogle Scholar
  5. 5.
    Dyken ML. Secondary prevention for stroke after CAPRIE and ESRS-2. Opinion 2. Cerebrovasc Dis 1998; 8: 75–7PubMedGoogle Scholar
  6. 6.
    Janzon L, Bergqvist D,Boberg J, et al. Prevention of myocardial infarction and stroke in patients with intermittent claudication: effects of ticlopidine. Results from STIMS, the Swedish Ticlopidine Multicentre Study. J Intern Med 1990; 227: 301–8PubMedCrossRefGoogle Scholar
  7. 7.
    Jackson MC, Clagett GP. Antithrombotic therapy in peripheral arterial occlusive disease. Chest 1998; 114(5 Suppl.): 666S–682SPubMedCrossRefGoogle Scholar
  8. 8.
    Balsano F, Rizzon P, Violi F, et al, STAI Group. Antiplatelet treatment with ticlopidine in unstable angina: a controlled multicenter clinical trial. Circulation 1990; 82: 17–26PubMedCrossRefGoogle Scholar
  9. 9.
    De Maat MP, Arnold AE, Van Buuren S, et al. Modulation of plasma fibrinogen levels by ticlopidine in healthy volunteers and patients with stable angina pectoris. Thromb Haemost 1996; 76: 166–70PubMedGoogle Scholar
  10. 10.
    Noble S, Goa KL. Ticlopidine. A review of its pharmacology, clinical efficacy and tolerability in the prevention of cerebral ischaemia and stroke. Drugs Aging 1996; 8: 214–32PubMedCrossRefGoogle Scholar
  11. 11.
    Tung C, Sauri D, Fintel D, et al. Management of high-risk subsets in unstable angina. Cardiol Clin 1999; 17: 415–37PubMedCrossRefGoogle Scholar
  12. 12.
    Mazur W, Kaluza G, Kleiman NS. Antiplatelet therapy for treatment of acute coronary syndromes. Cardiol Clin 1999; 17: 345–57PubMedCrossRefGoogle Scholar
  13. 13.
    Ito MK, Smith AR, Lee ML. Ticlopidine: a new platelet aggregation inhibitor. Clin Pharm 1992; 11: 603–17PubMedGoogle Scholar
  14. 14.
    Haynes RB, Sandier RS, Larson EB, et al. A critical appraisal of ticlopidine, a new antiplatelet agent. Effectiveness and clinical indications for prophylaxis of atherosclerotic events. Arch Intern Med 1992; 152: 1376–80PubMedCrossRefGoogle Scholar
  15. 15.
    Sanchez-Bisono JR, Gomez-Moli J, Escudero-Canto M. Probable ticlopidine-induced severe aplastic anemia and cholestatic hepatitis [letter]. Haematologica 1997; 82: 639PubMedGoogle Scholar
  16. 16.
    Ceylan C, Kirimli O, Akarsu M, et al. Early ticlopidine-induced hepatic dysfunction, dermatitis and irreversible aplastic anemia after coronary stenting [letter]. Am J Hematol 1998; 59: 260PubMedCrossRefGoogle Scholar
  17. 17.
    Martinez Perez-Balsa A, De Arce A, Castiella A, et al. Hepato-toxicity due to ticlopidine [letter]. Ann Pharmacother 1998; 32: 1250–1CrossRefGoogle Scholar
  18. 18.
    Iqbal M, Goenka P, Young MF, et al. Ticlopidine-induced cholestatic hepatitis: report of three cases and review of the literature. Dig Dis Sci 1998; 43: 2223–6PubMedCrossRefGoogle Scholar
  19. 19.
    Page Y, Tardy B, Zeni F, et al. Thrombotic thrombocytopenic purpura related to ticlopidine. Lancet 1991; 337: 774–6PubMedCrossRefGoogle Scholar
  20. 20.
    Kovacs MJ, Soong PY, Chin-Yee IH. Thrombotic thrombocytopenic purpura associated with ticlopidine. Ann Pharmacother 1993; 27: 1060–1PubMedGoogle Scholar
  21. 21.
    Weiner P, Zidan F, Paz R. Severe aplastic anemia due to ticlopidine. Isr JMed Sci 1995; 31: 444–5Google Scholar
  22. 22.
    Shapiro CM, Walk D. Aplastic anemia associated with ticlopidine. Neurology 1996; 47: 300PubMedCrossRefGoogle Scholar
  23. 23.
    Kao TW, Hung CC, Chen YC, et al. Ticlopidine-induced aplastic anemia: report of three Chinese patients and review of the literature. Acta Haematol 1997; 98: 211–3PubMedCrossRefGoogle Scholar
  24. 24.
    Bennet CL, Kiss JE, Weinberg PD. Thrombotic thrombocytopenic purpura after stenting and ticlopidine. Lancet 1998 352: 1036–7CrossRefGoogle Scholar
  25. 25.
    Gur H, Wartenfeld R, Tanne D, et al. Ticlopidine-induced severe neutropenia. Postgrad Med J 1998; 74: 126–7PubMedCrossRefGoogle Scholar
  26. 26.
    Love B, Biller J, Gentile M. Adverse haematological effects of ticlopidine: prevention, recognition and management. Drug Saf 1998; 19: 89–98PubMedCrossRefGoogle Scholar
  27. 27.
    Muszkat M, Shapira MY, Sviri S, et al. Ticlopidine-induced thrombotic thrombocytopenic purpura. Pharmacotherapy 1998; 18:1352–5PubMedGoogle Scholar
  28. 28.
    Yeh SP, Hsueh EJ, Wu H, et al. Ticlopidine-induced aplastic anemia. A case report and review of the literature. Ann Hematol 1998; 76: 87–90PubMedCrossRefGoogle Scholar
  29. 29.
    Chen DK, Kim JS, Sutton DMC. Thrombotic thrombocytopenic purpura associated with ticlopidine use: a report of 3 cases and review of the literature. Arch Intern Med 1999; 159: 311–4PubMedCrossRefGoogle Scholar
  30. 30.
    Elangovan L. Thrombotic thrombocytopenic purpura associated with ticlopidine use [letter]. Arch Intern Med 1999; 159: 1624PubMedCrossRefGoogle Scholar
  31. 31.
    Koornstra JJ, Loualidi A, de Vries CJ. Ticlopidine-induced thrombocytopenia. Neth J Med 1999; 54: 73–5PubMedCrossRefGoogle Scholar
  32. 32.
    Carlson JA, Maesner JE. Fatal neutropenia and thrombocytopenia associated with ticlopidine. Ann Pharmacother 1994; 28: 1236–8PubMedGoogle Scholar
  33. 33.
    Szto GYF, Linnemeier TJ, Ball MW. Fatal neutropenia and thrombocytopenia associated with ticlopidine after stenting. Am J Cardiol 1999; 83: 138–9PubMedCrossRefGoogle Scholar
  34. 34.
    Saltiel E, Ward A. Ticlopidine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in platelet-dependent disease states. Drugs 1987; 34: 222–62PubMedCrossRefGoogle Scholar
  35. 35.
    Hass WK, Easton JD, Adams Jr HP, et al. A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. N Engl J Med 1989; 321:501–7PubMedCrossRefGoogle Scholar
  36. 36.
    Gent M, Blakeley JA, Easton JD, et al. The Canadian American Ticlopidine Study (CATS) in thromboembolic stroke. Lancet 1989; 1: 1215–20PubMedCrossRefGoogle Scholar
  37. 37.
    Gregorini L, Marco J, Fajadet J, et al. Ticlopidine and aspirin pretreatment coagulation and platelet activation during coronary dilatation procedures. J An Coll Cardiol 1997; 29: 13–20CrossRefGoogle Scholar
  38. 38.
    Van de Loo A, Nauck M, Noory E, et al. Enhancement of platelet inhibition of ticlopidine plus aspirin vs aspirin alone given prior to elective PTCA. Eur Heart J 1998; 19: 96–102PubMedCrossRefGoogle Scholar
  39. 39.
    Schomig A, Neumann FJ, Kastrati A, et al. A randomized comparison of antiplatelet with anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med 1996; 334: 1084–9PubMedCrossRefGoogle Scholar
  40. 40.
    Ferrer F, Moraleda JM, Vicente V. Antithrombotic therapy after coronary-artery stenting [letter]. N Engl J Med 1999; 340: 1365–7PubMedCrossRefGoogle Scholar
  41. 41.
    Licoff AM, Califf RM, Moliterno DJ, et al. Complementary clinical benefits of coronary-artery stenting and blockade of platelet glycoprotein IIb/IIIa receptors. Evaluation of Platelet IIb/IIIa Inhibition in Stenting Investigators. N Engl J Med 1999; 341: 319–27CrossRefGoogle Scholar
  42. 42.
    Steinhubl SR, Tan WA, Foody JM, et al. Incidence and clinical course of thrombotic thrombocytopenic purpura due to ticlopidine following coronary stenting. EPISTENT Investigators. Evaluation of Platelet IIb/IIIa Inhibitor for Stenting.Google Scholar
  43. 43.
    Neumann FJ, Hall D, Schoming A. Neutropenia with ticlopidine plus aspirin [letter]. Lancet 1997; 24: 1552–3CrossRefGoogle Scholar
  44. 44.
    Haushofer A, Halbmayer WM, Prachar H. Neutropenia with ticlopidine plus aspirin [letter]. Lancet 1997; 15: 474–5CrossRefGoogle Scholar
  45. 45.
    De Gramont A, Canuel C, Krulik M, et al. Hematological toxicity of ticlopidine. Nouv Rev Fr Hematol 1982; 24: 35–7Google Scholar
  46. 46.
    Quaglini D, Venturoni L, Cretara G, et al. Reversible bone-marrow suppression primarily involving granulopoiesis following the use of ticlopidine. Haematologica 1982; 67: 940–1Google Scholar
  47. 47.
    Resegotti L, Pistone MA, Testa D, et al. Bone marrow culture in patients receiving ticlopidine treatment. Nouv Rev Fr Hematol 1985; 27: 19–22PubMedGoogle Scholar
  48. 48.
    Marinella MA. Agranulocytosis associated with ticlopidine: a possible benefit with filgastrim. Ann Clin Lab Sci 1997; 27: 418–21PubMedGoogle Scholar
  49. 49.
    Bahng H, Lee JH, Suh C, et al. Severe aplastic anemia induced by ticlopidine: report of two cases. J Korean Med Sci 1998; 13: 541–4PubMedGoogle Scholar
  50. 50.
    Ochoa AB, Wolfe M, Lewis P, et al. Ticlopidine-induced neutropenia mimicking sepsis early after intracoronary stent placement. Clin Cardiol 1998; 21: 304–7PubMedCrossRefGoogle Scholar
  51. 51.
    Bennett CL, Weinberg PD, Rozenberg-Ben-Dror K, et al. Thrombotic thrombocytopenic purpura associated with ticlopidine: a review of 60 cases. Ann Intern Med 1998; 1228: 541–4Google Scholar
  52. 52.
    Elias M, Reichaman N, Flatau E. Bone marrow aplasia associated with ticlopidine therapy [letter]. Am J Hematol 1993; 44: 289–91PubMedCrossRefGoogle Scholar
  53. 53.
    Mallet L, Mallet J. Ticlopidine and fatal aplastic anemia in an elderly woman. Ann Pharmacother 1994; 28: 1169–71PubMedGoogle Scholar
  54. 54.
    Dunn P. Aplastic anemia with ticlopidine therapy in two Chinese patients [letter]. Ann Pharmacother 1996; 30: 547PubMedGoogle Scholar
  55. 55.
    Mataix R, Ojeda E, Perez M, et al. Ticlopidine and severe aplastic anaemia. Br J Haematol 1992; 80: 125–6PubMedCrossRefGoogle Scholar
  56. 56.
    Thomson LEJ, Stewart JT. Ticlopidine induced agranulocytosis managed with granulocyte colony stimulating factor. N Z Med J 1998; 111:81–2PubMedGoogle Scholar
  57. 57.
    Abou-Khalil WH, Lim LO, Yunnis AA, et al. Effects of ticlopidine, a new platelet antiaggregating agent, and its analogues on mitochondrial metabolism. Oxidative phosphorylation, protein synthesis and DNA polymerase activity. Biochem Pharmacol 1984; 33: 3893–8PubMedCrossRefGoogle Scholar
  58. 58.
    Ono K, Kurohara K, Yoshihara M, et al. Agranulocytosis caused by ticlopidine and its mechanism. Am J Hematol 1991; 37: 239–42PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 2000

Authors and Affiliations

  • Massimo Gallerani
    • 1
  • R. Manfredini
    • 2
  • P. Donegà
    • 1
  • F. Lanza
    • 3
  • M. Da Busti
    • 3
  • G. B. Vigna
    • 1
  • R. Fellin
    • 1
  1. 1.Department of Clinical and Experimental Medicine, Section of Internal Medicine IIUniversity of FerraraFerraraItaly
  2. 2.Department of Clinical and Experimental Medicine, Section of Internal Medicine IUniversity of FerraraFerraraItaly
  3. 3.Department of Biomedical Science and Advanced Therapies, Section of HematologyUniversity of FerraraFerraraItaly

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