How to Treat Hereditary AT Deficiency

The goal of managing patients with hereditary antithrombin (AT) deficiency is to reduce the risk of thrombosis or thrombotic recurrence.

There is no widely accepted management protocol for hereditary AT deficiency. One study recommends the following steps¹:

	•	Evaluation of patient and family history—important in any hereditary condition
	•	Education and counseling of patients: specialized genetic counselors are available
	•	Diagnostic evaluation of children before 14 years of age but not before 2 years of age unless there is special clinical reason
	•	Initiation of preventive treatment for thrombosis in high-risk situations after 13 years of age, early in the course of pregnancy for women with hereditary AT deficiency, and in inhibitor-deficient females after childbirth

Long-term treatment for patients who have had a thrombotic event:

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While there is debate in the clinical community about the wisdom of long-term anticoagulation therapy, oral anticoagulants remain an option for patients who have had a thrombotic event

Short-term treatment for high-risk events, including surgical or obstetrical procedures or thromboembolism:

	•	Thrombate III is the only treatment approved by the FDA
	•	When an infusion of Thrombate III is indicated, it is desirable to raise the AT level to normal and maintain this level for 2 to 8 days
			–	Take into account the indication for treatment, type and extent of surgery, patient's medical condition, past history, and physician's judgment
			–	Concomitant administration of heparin in each of these situations should be based on the medical judgment of the physician2

Please see Dosing and Administration.

For clinical questions about Thrombate III, please contact Talecris Clinical Communications: 1-800-520-2807.

References:

1.		Pabinger I, Schneider B, for the Gesellschaft fur Thrombose- und Hamostaseforschung (GTH) Study Group on Natural Inhibitors. Thrombotic risk in hereditary antithrombin III, protein C, or protein S deficiency: a cooperative retrospective study. Arterioscl Thromb Vasc Biol. 1996;16:742-748.
2.		Thrombate III [prescribing information]. Research Triangle Park, NC; Talecris Biotherapeutics, Inc.; 2006.