Reduced half-life of recombinant ADAMTS13 in a patient with cTTP undergoing total hip arthroplasty

A 41 year old female with congenital thrombotic thrombocytopenic purpura (cTTP) underwent a total hip arthroplasty under prophylaxis with recombinant ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin motifs 13). The procedure was performed without complications 12 h after the last injection. Postoperative ADAMTS13 activity levels showed a more rapid decrease in activity and in the individual apparent half-life due to increased consumption of the recombinant protease that could safely be managed by an intensified dosing regimen.