Microsoft word - protonix abstract for society of blood 2006.doc

THE PREVALENCE OF PANTOPROZOLE ASSOCIATED
THROMBOCYTOPENIA IN A COMMUNITY HOSPITAL –A
RETROSPECTIVE STUDY
Efrat Dotan, MD; Randi Katz, DO; Jason Bratcher, MD Sivakumar Reddy, MD;
Carrie Wasserman, DO; Michelene Liebman, MD; Amy Michel, PharmD; Aliasad
Arastu, MD; Georgia Panagopoulos, PhD; Colette Spaccavento, MD
Division of Hematology and Oncology, Department of Medicine
Lenox Hill Hospital
Introduction:
Proton Pump Inhibitors (PPIs) are widely used in the treatment of Peptic Ulcer Disease,
Helicobacter pylori (H pylori) Gastritis and Gastro-Esophageal Reflux Disease. PPIs are
known to be relatively safe medications, with the most common side effects reported as
diarrhea, nausea, vomiting, abdominal pain and headache. Thrombocytopenia has not
been found to be a significant problem with PPI use. In our hospital, we observed a
potential increase in the rate of thrombocytopenia in patients treated with PPIs.
However this association has not previously been confirmed in the literature. The
objective of this study was to determine the actual prevalence of thrombocytopenia in
hospitalized patients treated with pantoprazole, compared to non-medicated controls.
Methods:
This study was a retrospective cohort study in an urban community hospital. We analyzed
the platelet counts of 626 patients between 18 and 80 years of age who were hospitalized
and were prescribed pantoprazole for a minimum of three days during their hospital
admission. We defined thrombocytopenia as a drop in the platelet count to below
150,000/ml from normal, or a drop of 50 percent or more from admission platelet count.
Exclusion criteria were platelet counts below 150,000/ml on admission and
hospitalization for less than three days. The control group consisted of 560 randomly
selected patients who were hospitalized for greater then three days and were not treated
with pantoprazole.
Results:
The analysis of patient characteristics revealed an older patient population with a
significantly longer length of hospitalization in the study group compared to the control
group (67.5years +/- 15.7years vs. 61.1years +/- 18.0years respectively; p<0.001); (10.16
days versus 6.7 days respectively; P<0.001). Despite of the aforementioned difference, no
difference was found in the prevalence of thrombocytopenia between the two groups,
6.2% (95% CI 4%-8%) in the study group versus 6.2% (95%CI 4%-8%) in the control
group (P=0.90). Similarly no significant difference was found in the rate of transient
thrombocytopenia between the two groups. However, significantly more patients in the
study group experienced a greater than 20 percent drop in platelet count while treated
with pantoprazole, compared to the control group (20%; 95%CI: 16-23% vs. 11.4%;
95%CI: 9-14%) (p<0.001).
Conclusion:
According to our results the prevalence of thrombocytopenia is not increased with the use
of pantoprazole. Our study adds further evidence to the favorable safety profile of
pantoprazole in hospitalized patients. Further investigation is needed to determine if this
holds true in the outpatient setting.

Source: http://soc-study-blood.tripod.com/SSB/Fellows/Dotan.pdf