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Treatment of disseminated intravascular coagulation with gabexate mesilate
1Second Department of Internal Medicine, Mie University School of Medicine, Japan.
Insights
Gabexate mesilate (FOY) effectively treated patients with disseminated intravascular coagulation (DIC) and pre-DIC, improving organ function and reducing bleeding. The treatment significantly lowered DIC scores and improved remission rates in both leukemic and non-leukemic patients.
Area of Science:
- Hematology
- Pharmacology
Background:
- Disseminated intravascular coagulation (DIC) and pre-DIC are critical conditions with high rates of organ failure and bleeding.
- Effective therapeutic agents are needed to manage these complex hemostatic disorders.
Purpose of the Study:
- To evaluate the efficacy of gabexate mesilate (FOY) in treating patients with DIC and pre-DIC.
- To assess the impact of FOY on organ function, bleeding tendencies, and coagulation parameters.
Main Methods:
- A cohort of 215 DIC patients and 146 pre-DIC patients received gabexate mesilate (FOY) treatment.
- Pre- and post-treatment assessments included organ failure, bleeding tendency, hemostatic studies, and DIC scores.
- Remission and exacerbation rates were analyzed for leukemic and non-leukemic subgroups.
Main Results:
- FOY treatment resolved organ failure in 16% of DIC and 17% of pre-DIC patients.
- Bleeding tendencies improved in 32% of DIC and 30% of pre-DIC patients.
- Significant improvements in coagulation parameters, reduced DIC scores, and favorable remission rates were observed.
Conclusions:
- Gabexate mesilate (FOY) demonstrates significant therapeutic benefits in managing DIC and pre-DIC.
- FOY effectively improves organ function, ameliorates bleeding, and normalizes coagulation profiles.
- The drug shows promise in achieving remission and improving outcomes for patients with these coagulation disorders.
Abstract:
Gabexate mesilate (FOY) was used to treat 215 patients with disseminated intravascular coagulation (DIC) and 146 patients with a predisposition to DIC (pre-DIC). Sixty percent of DIC patients and 48% of pre-DIC patients exhibited pretreatment organ failure, which resolved after FOY treatment in 16% of DIC patients and 17% of pre-DIC patients. Seventy percent of DIC patients and 49% of pre-DIC patients had a pretreatment bleeding tendency that was ameliorated by FOY treatment in 32% of DIC patients and 30% of pre-DIC patients. Comparison of pretreatment and posttreatment hemostatic studies of the DIC patients revealed that platelet count and levels of fibrinogen degradation products (FDP), thrombin-antithrombin-III complex, and FDP-D-dimer decreased significantly; fibrinogen level increased markedly; and prothrombin time was prolonged. DIC scores were significantly lowered in both leukemic and nonleukemic patients from the third day of treatment with FOY. Among leukemic DIC patients, 59% showed complete remission (CR), 21% partial remission (PR), and 7% exacerbation of their condition; 46% of the nonleukemic DIC patients demonstrated CR, 17% PR, and 17% exacerbation. Of the leukemic pre-DIC patients, 59% showed improvement and 7% exacerbation, whereas 55% of the nonleukemic pre-DIC patients showed improvement and 27% exacerbation.