Gabexate mesilate (FOY) therapy of disseminated intravascular coagulation due to sepsis
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Abstract:
Gabexate mesilate (FOY), a synthetic serine proteinase inhibitor, has an anticoagulant activity in the absence of antithrombin-III. We investigated FOY therapy for the treatment of disseminated intravascular coagulation (DIC) associated with sepsis in 15 patients (group F), and compared it with heparin therapy in 8 patients (group H). Successful treatment was observed in 13 patients in group F and in 4 patients in group H. The efficacy of the therapy in both groups was not significantly different. However, in patients whose antithrombin-III values were less than 20 mg/dl at the initiation of the therapy, FOY therapy was successful in 6 of 7 patients, whereas heparin therapy was not at all successful in 4 patients (rho less than 0.05). We conclude that FOY can be used as effectively as heparin for the treatment of DIC, and that FOY therapy is superior to heparin therapy in DIC associated with decreased antithrombin-III.
Insights
Gabexate mesilate (FOY) effectively treats disseminated intravascular coagulation (DIC) associated with sepsis. FOY shows superior efficacy compared to heparin in DIC patients with low antithrombin-III levels.
Area of Science:
- Pharmacology
- Hematology
- Critical Care Medicine
Background:
- Disseminated intravascular coagulation (DIC) is a life-threatening condition often associated with sepsis.
- Antithrombin-III (AT-III) deficiency can complicate DIC treatment, particularly with heparin therapy.
- Gabexate mesilate (FOY) is a synthetic serine proteinase inhibitor with anticoagulant properties independent of AT-III.
Purpose of the Study:
- To investigate the efficacy of gabexate mesilate (FOY) in treating sepsis-associated DIC.
- To compare the effectiveness of FOY therapy with heparin therapy in DIC patients.
- To evaluate FOY's performance in DIC patients with varying AT-III levels.
Main Methods:
- A comparative study involving 15 patients treated with FOY (group F) and 8 patients treated with heparin (group H) for sepsis-associated DIC.
- Assessment of treatment success rates in both groups.
- Analysis of treatment outcomes based on initial antithrombin-III levels.
Main Results:
- Successful treatment was achieved in 13 of 15 patients (86.7%) in the FOY group versus 4 of 8 patients (50%) in the heparin group.
- Overall treatment efficacy was not significantly different between the two groups.
- FOY therapy demonstrated significantly higher success rates (6/7 patients) in patients with AT-III levels below 20 mg/dl, whereas heparin therapy was unsuccessful in all 4 such patients (p < 0.05).
Conclusions:
- Gabexate mesilate (FOY) is an effective alternative to heparin for treating sepsis-associated DIC.
- FOY therapy offers a significant advantage over heparin in managing DIC patients with pre-existing low antithrombin-III levels.
- FOY represents a valuable therapeutic option for DIC, especially in complex cases involving AT-III deficiency.