In 2 data series, the rate of thromboembolic complication in surgical patients with hereditary AT deficiency ranged from 17% to 22%1,2


SURGICAL CASE STUDY: ROBERT

Age:40 years

Height5'11"

Weight190 lb (86 kg)



 

Family History: Deep vein thrombosis, peripheral artery disease, and myocardial infarction

Chief Complaint: Tightness of the chest, back, and shoulders

Initial Evaluation/Suggested Treatment: Atherosclerosis and occlusion of the left anterior descending branch requiring coronary artery bypass grafting (CABG)

Complication: Hereditary AT deficiency (AT activity 48% of normal)

Treatment Goals and Plan: To prevent thrombotic complications, AT activity will be increased from 48% to 120% of normal on the day of surgery with Thrombate IIIᆴ (antithrombin III [human]). Robert will continue treatment throughout the duration of his hospital stay to maintain his levels at 80% to 120% of normal

 

Hereditary AT deficiency
increases thrombotic risk 20-fold


 


Thrombate III® (antithrombin III [human]) is indicated for the treatment of patients with hereditary antithrombin deficiency in connection with surgical or obstetrical procedures or when they suffer from thromboembolism.

In clinical studies, the most common adverse events were dizziness, chest discomfort, nausea, and dysgeusia.

The anticoagulant effect of heparin is enhanced by concurrent treatment with Thrombate III in patients with hereditary AT-III deficiency. Thus, in order to avoid bleeding, reduced dosage of heparin is recommended during treatment with Thrombate III.

Thrombate III is made from human plasma. Plasma products carry a risk of transmitting infectious agents, such as viruses, and theoretically, the Creutzfeldt-Jakob disease (CJD) agent, despite steps designed to reduce this risk. No cases of transmission of viral disease or CJD have ever been identified for Thrombate III.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.


References

  1. Tengborn L, Bergqvist D. Surgery in patients with congenital antithrombin III deficiency. Acta Chir Scand. 1988;154(3):179-183.
  2. Pabinger I, Schneider B. Thrombotic risk in hereditary antithrombin III, protein C, or protein S deficiency. A cooperative, retrospective study. Gesellschaft fur Thrombose-und Hamostaseforschung (GTH) Study Group on Natural Inhibitors. Arterioscler Thromb Vasc Biol . 1996;16(6):742-748.