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Capped antithrombin III dosing is cost effective in the management of asparaginase-associated thrombosis

Jennifer Young1, Jaclyn Sawyer1, Meredith Jenkins1

  • 1Division of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Pediatric Blood & Cancer
|March 23, 2019
PubMed

Insights

Asparaginase therapy can cause thrombosis due to antithrombin III (ATIII) deficiency. Capped dosing of ATIII supplementation during enoxaparin treatment showed significant cost savings in oncology patients.

Area of Science:

  • Oncology
  • Hematology
  • Pharmacoeconomics

Background:

  • Asparaginase therapy, used in oncology, can lead to antithrombin III (ATIII) deficiency.
  • This ATIII deficiency increases the risk of thrombosis in patients undergoing asparaginase treatment.
  • Current management involves ATIII supplementation alongside enoxaparin for asparaginase-induced thrombosis.

Purpose of the Study:

  • To evaluate a capped dosing strategy for antithrombin III (ATIII) supplementation in oncology patients.
  • To assess the cost-effectiveness of capped ATIII dosing compared to standard protocols.
  • To determine the response of peak ATIII levels following capped ATIII doses.

Main Methods:

  • A pilot evaluation was conducted at Cincinnati Children's Hospital Medical Center.
  • Eleven patients received a total of 138 capped doses of ATIII.
  • Peak ATIII levels were monitored after capped dose administration.

Main Results:

  • The capped dosing approach resulted in significant cost savings of $803,782.
  • This strategy was implemented during therapeutic anticoagulation with enoxaparin.
  • This represents the first analysis of capped ATIII dosing in oncology patients.

Conclusions:

  • Capped ATIII dosing is a potentially cost-saving strategy for managing asparaginase-induced thrombosis.
  • Further studies are warranted to confirm the efficacy and safety of this approach.
  • This pilot evaluation demonstrates the feasibility of optimizing ATIII supplementation costs in cancer care.

Keywords:
antithrombin IIIasparaginase-induced thrombosiscapped antithrombin III

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