Antithrombin III concentrates--are they clinically useful?

Area of Science:

• Hematology
• Thrombosis and Hemostasis

Background:

• Antithrombin III (AT III) concentrates were developed with optimistic expectations based on theoretical and animal studies.
• Despite widespread clinical use for over 15 years, a clear patient benefit from AT III concentrates remains unproven.

Purpose of the Study:

• To evaluate the clinical efficacy of Antithrombin III (AT III) concentrate treatment.
• To assess the discrepancy between theoretical benefits and clinical outcomes of AT III concentrate therapy.

Main Methods:

• Review of existing clinical studies, including randomized trials, on AT III concentrate treatment.
• Analysis of data concerning morbidity and mortality reduction in patients treated with AT III concentrates.

Main Results:

• No significant clinical benefit regarding morbidity or mortality reduction was detected in randomized trials for AT III concentrate treatment.
• Randomized clinical trials are lacking for hereditary antithrombin III deficiency.
• Few small randomized studies exist for acquired AT III deficiency, none showing significant clinical benefit.

Conclusions:

• AT III concentrates may offer benefits in specific clinical situations for hereditary antithrombin III deficiency, such as during delivery, for severe thromboembolic events, or for postoperative prophylaxis.
• Currently, there is no proven indication for using AT III concentrates in acquired antithrombin III deficiency.