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Comparative Accuracy of SPECT/CT Imaging versus Lumbar Medial Branch Blocks in Localizing Facet Arthritis
No full texthttps://scholarlycommons.baptisthealth.net/bhsf-academic-week-2025/1050/thumbnail.jp
Percutaneous Tenotomy with Ultrasonic Debridement for Lateral Epicondylitis: Surgical Technique and Short Term Patient Outcomes
No full texthttps://scholarlycommons.baptisthealth.net/bhsf-academic-week-2025/1063/thumbnail.jp
The Multifaceted Roles of Vps9 Domain Proteins: From Structural Insights to Biological Disease Implications
No full texthttps://scholarlycommons.baptisthealth.net/bhsf-academic-week-2025/1093/thumbnail.jp
Biliary Breach: A Rare Case of Biliary Pleural Fistula Without History of Trauma
No full texthttps://scholarlycommons.baptisthealth.net/bhsf-academic-week-2025/1187/thumbnail.jp
Extra-central nervous system metastasis from high-grade glioma: a single-institution experience
No full textMoving From the Background Toward the Spotlight: A Critical Review of Radiation Therapy for Locally Advanced Pancreas Cancer
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Role of Metastasectomy for Tissue Acquisition for Tumor-Infiltrating Lymphocyte Harvest and Biomarker/Genomic Testing
No full textCaplacizumab use in immune-mediated thrombotic thrombocytopenic purpura: an international multicentre retrospective Cohort study (The Capla 1000+ project)
No full textBackground: The anti-Von Willebrand Factor (VWF) nanobody caplacizumab is licensed for adults with immune-mediated thrombotic thrombocytopenic purpura (iTTP) in association with therapeutic plasma exchange (TPE) and immunosuppression. However, whether caplacizumab reduces mortality, and its optimal timing of initiation, is not completely settled.
Methods: This international, multicenter retrospective cohort study recruited patients from 2018 until 2023 and data collection took place from January 1st to June 30th 2023 in the participating centers. One thousand and fifteen patients were treated with daily TPE, immunosuppression with corticosteroids ± rituximab, and caplacizumab (caplacizumab group), which was compared to historic controls treated with TPE and corticosteroids ± rituximab (control group, N = 510). Caplacizumab initiation was classified as early (within 3 days; 76% of cases) or delayed (≥4 days from first TPE).
Findings: Three-month survival rate in the caplacizumab group was 98.5%, compared with 94% in controls (P \u3c 0.0001). Three-month mortality rate was 4.2-fold higher in controls than in caplacizumab-treated patients (95% CI: 2.22-7.7, P \u3c 0.0001), regardless of rituximab use. In both groups, death was observed primarily in elderly patients, and age was the factor most associated with 3-month mortality. Patients receiving caplacizumab showed reduced refractoriness, exacerbations, and required fewer TPE sessions to achieve clinical response versus controls (P \u3c 0.0001 all). Time to clinical response in the caplacizumab group was shorter than in controls, and even shorter in patients with early caplacizumab initiation (P \u3c 0.0001 both). Caplacizumab-related adverse events were observed in 21% of patients, with major bleeding in 2.4%, which was more common in elderly patients.
Interpretation: The early association of Caplacizumab to TPE and immunosuppression significantly reduces unfavorable outcomes during iTTP, including death, and alleviates the burden of care at the potential expense of bleeding events. Advanced age, however, remains an adverse factor for survival. The limitations of our study include its retrospective and multicentric design and the use of a historical control cohort
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