Caplacizumab treatment in elderly patients with iTTP: Experience from the Spanish TTP Registry
Immune thrombotic thrombocytopenic purpura (iTTP) typically affects middle-aged individuals, although it sometimes appears in older patients. Caplacizumab is approved for the treatment of iTTP, but information on the safety and efficacy of this drug in elderly patients is not available. We aimed to analyze the management and outcomes of iTTP patients registered in the Spanish TTP Registry and receiving caplacizumab at any time during the acute episode, focusing on patients ≥60 years (<i>n</i> = 29) and comparing them with patients <60 years (<i>n</i> = 70). Severe bleeding motivated caplacizumab's initiation delay in one patient ≥60 years. Patients receiving anticoagulation or antiplatelet therapy at diagnosis were more common in older patients (10% vs. 1%; <i>p</i> = 0.074), as well as the occurrence of bleeding motivating caplacizumab discontinuation (17% vs. 1%, respectively; <i>p</i> = 0.008). Caplacizumab seemed to be efficient in the treatment of iTTP in older patients, reducing refractoriness and death to 3% and exacerbation to 10%, similar to younger patients. The higher risk of bleeding in this older population warrants the need for close monitoring during treatment and to further explore the best management of thrombotic and bleeding risk.
Authors
- Miquel Lozano (ORCID: https://orcid.org/0000-0003-2593-833X)
- Joan Cid (ORCID: https://orcid.org/0000-0001-5445-4508)
- David Valcárcel (ORCID: https://orcid.org/0000-0002-8747-078X)
- Rosa Goterris (ORCID: https://orcid.org/0000-0003-0476-9696)
- Javier de la Rubia (ORCID: https://orcid.org/0000-0002-8354-768X)
- María Eva Mingot‐Castellano (ORCID: https://orcid.org/0000-0001-9083-855X)
- Moraima Jiménez (ORCID: https://orcid.org/0000-0003-1444-8562)
- Jorge Martínez Nieto (ORCID: https://orcid.org/0000-0001-9075-7100)
- Sunil Lakhwani (ORCID: https://orcid.org/0000-0003-1984-4839)
- José María García‐Gala (ORCID: https://orcid.org/0000-0001-5992-1961)
- Marta Fernández Docampo
- Clara Cuéllar Pérez-Ávila
- Faustino García‐Candel (ORCID: https://orcid.org/0000-0002-6369-6004)
- Inés Gómez‐Seguí (ORCID: https://orcid.org/0000-0002-0679-2905)
- Clara Sopeña Pell‐Ilderton
- Maria Arraiz Ramirez
- Cristina Pascual (ORCID: https://orcid.org/0000-0001-5442-4886)
- Maria Gemma Moreno Jimenez
- Luz Maria Gonzalez del Castillo
- Julia Maria Vidan Estevez
- ANA Yurena Oliva Hernandez
Institutions
- Hospital Universitario de Canarias (ES)
- Valencia Catholic University Saint Vincent Martyr (ES)
- Hospital General Universitario Gregorio Marañón (ES)
- Hospital Clínico San Carlos (ES)
- Hospital Universitari i Politècnic La Fe (ES)
- Research Institute Hospital 12 de Octubre (ES)
- Hospital Universitario Nuestra Señora de Candelaria (ES)
- Hospital Clínico Universitario de Valencia (ES)
- Hospital Universitario de Gran Canaria Doctor Negrín (ES)
- Hospital Clínic de Barcelona (ES)
- Vall d'Hebron Hospital Universitari (ES)
- Instituto de Biomedicina de Sevilla (ES)
- Hospital Universitario Central de Asturias (ES)
- Complexo Hospitalario Universitario A Coruña (ES)
- Hospital Universitario Virgen de la Arrixaca (ES)
- Hospital Universitario Virgen del Rocío (ES)
- Hospital Universitario de León (ES)
- Hospital Universitario Ramón y Cajal (ES)
- Instituto de Investigación Sanitaria La Fe (ES)
- Universidad de Sevilla (ES)
Publication Details
- Journal
- HemaSphere
- Published
- 2025-04-01
- DOI
- https://doi.org/10.1002/hem3.70109
- Citations
- 2
- Primary Topic
- Complement system in diseases
- Type
- article
- Field-Weighted Citation Impact
- 1.59