Evaluation of Global Hemostatic Assays in Response to Factor VIII Inhibitors
Global hemostatic assays including thromboelastography (TEG), Innovance ETP (endogenous thrombin potential), and Thrombinoscope could measure thrombin generation potential and be useful to guide management of patients with factor VIII (FVIII) inhibitors. However, the performance characteristics of t...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-03-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/1076029619836171 |
| _version_ | 1819159961504055296 |
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| author | Ping Chen MD, PhD Jayesh Jani MS Michael B. Streiff MD Gang Zheng MD, PhD Thomas S. Kickler MD |
| author_facet | Ping Chen MD, PhD Jayesh Jani MS Michael B. Streiff MD Gang Zheng MD, PhD Thomas S. Kickler MD |
| author_sort | Ping Chen MD, PhD |
| collection | DOAJ |
| description | Global hemostatic assays including thromboelastography (TEG), Innovance ETP (endogenous thrombin potential), and Thrombinoscope could measure thrombin generation potential and be useful to guide management of patients with factor VIII (FVIII) inhibitors. However, the performance characteristics of these global assays in the presence of FVIII inhibitors are incompletely characterized. In this study, the normal range of thrombin generation potential was measured in 20 healthy individuals by all 3 assays. In 5 commercial and 7 clinical samples with FVIII inhibitors, it was shown that PPP-reagent thrombinoscope shows a dose-dependent response to different levels of FVIII inhibitors from the same patients, while Innovance ETP shows virtually no response to FVIII inhibitors. The TEG is more sensitive to FVIII inhibitors than thrombinoscope. Importantly, we show the same levels of FVIII inhibitor from different patients results in different levels of inhibition for thrombin generation potential by thrombinoscope, which potentially explains the phenotypic heterogeneity of patients with FVIII inhibitors. Global assays such as thrombinoscope, but not Innovance ETP, show appropriate sensitivity to FVIII inhibitors that could offer an objective and clinically relevant marker to guide patient management. |
| first_indexed | 2024-12-22T16:48:52Z |
| format | Article |
| id | doaj.art-7eff9ed9cfcf4dcfb6767684fc531840 |
| institution | Directory Open Access Journal |
| issn | 1938-2723 |
| language | English |
| last_indexed | 2024-12-22T16:48:52Z |
| publishDate | 2019-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj.art-7eff9ed9cfcf4dcfb6767684fc5318402022-12-21T18:19:38ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232019-03-012510.1177/1076029619836171Evaluation of Global Hemostatic Assays in Response to Factor VIII InhibitorsPing Chen MD, PhD0Jayesh Jani MS1Michael B. Streiff MD2Gang Zheng MD, PhD3Thomas S. Kickler MD4 Department of Hematology, Jinan Central Hospital, Shandong University, Jinan, China Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USAGlobal hemostatic assays including thromboelastography (TEG), Innovance ETP (endogenous thrombin potential), and Thrombinoscope could measure thrombin generation potential and be useful to guide management of patients with factor VIII (FVIII) inhibitors. However, the performance characteristics of these global assays in the presence of FVIII inhibitors are incompletely characterized. In this study, the normal range of thrombin generation potential was measured in 20 healthy individuals by all 3 assays. In 5 commercial and 7 clinical samples with FVIII inhibitors, it was shown that PPP-reagent thrombinoscope shows a dose-dependent response to different levels of FVIII inhibitors from the same patients, while Innovance ETP shows virtually no response to FVIII inhibitors. The TEG is more sensitive to FVIII inhibitors than thrombinoscope. Importantly, we show the same levels of FVIII inhibitor from different patients results in different levels of inhibition for thrombin generation potential by thrombinoscope, which potentially explains the phenotypic heterogeneity of patients with FVIII inhibitors. Global assays such as thrombinoscope, but not Innovance ETP, show appropriate sensitivity to FVIII inhibitors that could offer an objective and clinically relevant marker to guide patient management.https://doi.org/10.1177/1076029619836171 |
| spellingShingle | Ping Chen MD, PhD Jayesh Jani MS Michael B. Streiff MD Gang Zheng MD, PhD Thomas S. Kickler MD Evaluation of Global Hemostatic Assays in Response to Factor VIII Inhibitors Clinical and Applied Thrombosis/Hemostasis |
| title | Evaluation of Global Hemostatic Assays in Response to Factor VIII Inhibitors |
| title_full | Evaluation of Global Hemostatic Assays in Response to Factor VIII Inhibitors |
| title_fullStr | Evaluation of Global Hemostatic Assays in Response to Factor VIII Inhibitors |
| title_full_unstemmed | Evaluation of Global Hemostatic Assays in Response to Factor VIII Inhibitors |
| title_short | Evaluation of Global Hemostatic Assays in Response to Factor VIII Inhibitors |
| title_sort | evaluation of global hemostatic assays in response to factor viii inhibitors |
| url | https://doi.org/10.1177/1076029619836171 |
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