去纤苷治疗肝小静脉闭塞容易出血吗？

Defibrotide treatment of hepatic venule occlusion is prone to bleeding.

Causes and treatment of bleeding

It can increase plasmin activity and anti-thrombotic activity in vitro, and may increase the risk of bleeding in VOD patients after hematopoietic cell transplantation. Bleeding can manifest as epistaxis, alveolar hemorrhage, gastrointestinal bleeding, pulmonary hemorrhage, intracranial hemorrhage, etc.

Do not defibrillate patients with active bleeding and monitor patients for signs of bleeding. If bleeding occurs in a patient receiving defibrotide, defibrotide therapy should be discontinued, the underlying cause treated, and supportive care provided until bleeding ceases.

Concomitant use of defibrotide and systemic anticoagulation or fibrinolytic therapy may increase the risk of bleeding. Before treating fibrinolysis, discontinue anticoagulants and fibrinolytic agents and consider delaying initiation of dosing until the effects of the anticoagulants have diminished.

If you experience abnormal bleeding, easy bruising, blood in urine or stool, headache, confusion, slurred speech, or changes in vision while taking this medication, be sure to inform your doctor immediately.

Defibrinoside side effects

The most common are hypotension, diarrhea, vomiting, nausea and epistaxis. The most common serious adverse reactions are hypotension and alveolar hemorrhage. Adverse reactions leading to permanent discontinuation include alveolar hemorrhage, pulmonary hemorrhage, hypotension, catheter site hemorrhage, multiple organ failure, cerebral hemorrhage and sepsis.

Advantages of defibrotide hepatic veno-occlusive disease

Hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), is a potentially life-threatening complication of hematopoietic stem cell transplantation (HSCT). Untreated hepatic VOD/SOS with multiple organ failure (MOF) is associated with over 80% mortality.

In a phase 2 study, defibrotide showed good efficacy in treating hepatic VOD/SOS with MOF. Assisting in a Phase 3 study investigating the safety and efficacy of defibrotide in patients with established hepatic VOD/SOS and advanced MOF. Patients taking 25 mg/kg of defibrotide daily (n=102) were compared with 32 historical controls from the medical records of 6867 HSCT patients.

The +100-day complete remission (CR) rate was 25.5% in the defibrotide group compared with 12.5% in the control group, and defibrotide was associated with significant improvements in +100-day survival and CR rates.

Recommended related articles: