{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1363670318947717248.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1182/blood.v96.7.2373"}},{"identifier":{"@type":"URI","@value":"http://ashpublications.org/blood/article-pdf/96/7/2373/1667917/h8190002373.pdf"}}],"dc:title":[{"@value":"Antihirudin antibodies in patients with heparin-induced thrombocytopenia treated with lepirudin: incidence, effects on aPTT, and clinical relevance"}],"description":[{"type":"abstract","notation":[{"@value":"<jats:title>Abstract</jats:title>\n               <jats:p>Hirudin, a potent and specific thrombin inhibitor, is a protein of nonhuman origin and therefore potentially immunogenic. The primary objectives of this investigation were to determine the incidence of antihirudin antibodies (ahir-ab) in patients with heparin-induced thrombocytopenia (HIT) who received lepirudin as parenteral anticoagulation and to determine the incidence of death, limb amputation, new thromboembolic complications (TECs), and major hemorrhage in patients who had ahir-ab, compared with patients who were ahir-ab negative. The investigation used data from 2 prospective multicenter studies with the same study protocol, in which HIT patients received 1 of 4 intravenous lepirudin dosage regimens. The treatment duration was 2 to 10 days. Ahir-ab were determined by a newly developed enzyme-linked immunosorbent assay (ELISA). Eighty-seven of 196 evaluable patients (44.4%) had ahir-ab of the IgG class. Development of ahir-ab was dependent on the duration of treatment (ahir-ab–positive patients 18.6 days vs ahir-ab–negative patients 11.8 days; P = .0001). Fewer ahir-ab–positive than ahir-ab–negative patients died (P = .001). Ahir-ab did not cause an increase in limb amputation (P = .765), new TECs (P &gt; .99), or major bleedings (P = .549). In 23 of 51 (45.1%) evaluable patients in whom ahir-ab developed during treatment with lepirudin ( = 12% of all lepirudin treated patients), the ahir-ab enhanced the anticoagulatory effect of lepirudin. Ahir-ab are frequent in patients treated with lepirudin for more than 5 days. Ahir-ab are the first example for a drug-induced immune response causing enhanced activity of a drug. Therefore, during prolonged treatment with lepirudin, anticoagulatory activity should be monitored daily to avoid bleeding complications.</jats:p>"}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1383670318947717252","@type":"Researcher","foaf:name":[{"@value":"Petra Eichler"}],"jpcoar:affiliationName":[{"@value":"From the Institute for Immunology and Transfusion Medicine and Institute for Biometry and Medical Informatics, Ernst-Moritz-Arndt-University, Greifswald, Germany; Hoechst Marion Roussel Deutschland GmbH, Marburg, Germany."}]},{"@id":"https://cir.nii.ac.jp/crid/1383670318947717249","@type":"Researcher","foaf:name":[{"@value":"Heinz-Juergen Friesen"}],"jpcoar:affiliationName":[{"@value":"From the Institute for Immunology and Transfusion Medicine and Institute for Biometry and Medical Informatics, Ernst-Moritz-Arndt-University, Greifswald, Germany; Hoechst Marion Roussel Deutschland GmbH, Marburg, Germany."}]},{"@id":"https://cir.nii.ac.jp/crid/1383670318947717251","@type":"Researcher","foaf:name":[{"@value":"Norbert Lubenow"}],"jpcoar:affiliationName":[{"@value":"From the Institute for Immunology and Transfusion Medicine and Institute for Biometry and Medical Informatics, Ernst-Moritz-Arndt-University, Greifswald, Germany; Hoechst Marion Roussel Deutschland GmbH, Marburg, Germany."}]},{"@id":"https://cir.nii.ac.jp/crid/1383670318947717250","@type":"Researcher","foaf:name":[{"@value":"Bernd Jaeger"}],"jpcoar:affiliationName":[{"@value":"From the Institute for Immunology and Transfusion Medicine and Institute for Biometry and Medical Informatics, Ernst-Moritz-Arndt-University, Greifswald, Germany; Hoechst Marion Roussel Deutschland GmbH, Marburg, Germany."}]},{"@id":"https://cir.nii.ac.jp/crid/1383670318947717248","@type":"Researcher","foaf:name":[{"@value":"Andreas Greinacher"}],"jpcoar:affiliationName":[{"@value":"From the Institute for Immunology and Transfusion Medicine and Institute for Biometry and Medical Informatics, Ernst-Moritz-Arndt-University, Greifswald, Germany; Hoechst Marion Roussel Deutschland GmbH, Marburg, Germany."}]}],"publication":{"publicationIdentifier":[{"@type":"EISSN","@value":"15280020"},{"@type":"PISSN","@value":"00064971"}],"prism:publicationName":[{"@value":"Blood"}],"dc:publisher":[{"@value":"American Society of Hematology"}],"prism:publicationDate":"2000-10-01","prism:volume":"96","prism:number":"7","prism:startingPage":"2373","prism:endingPage":"2378"},"reviewed":"false","url":[{"@id":"http://ashpublications.org/blood/article-pdf/96/7/2373/1667917/h8190002373.pdf"}],"createdAt":"2019-10-13","modifiedAt":"2020-02-12","relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1390001204445088384","@type":"Article","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Heparin-Induced Thrombocytopenia and Treatment with Thrombin Inhibitors"}]}],"dataSourceIdentifier":[{"@type":"CROSSREF","@value":"10.1182/blood.v96.7.2373"},{"@type":"CROSSREF","@value":"10.2491/jjsth.16.623_references_DOI_BhWDlq1f1gpCDWO5HEhR6PGWX1t"}]}