去纤苷的的副作用与注意事项

Defibrotide is an important drug used to treat hepatic veno-occlusive disease (VOD) after hematopoietic stem cell transplantation (HSCT). It has anti-thrombotic and fibrinolytic effects. Despite its remarkable efficacy, adverse reactions may occur during use, such as hypotension, gastrointestinal symptoms, and risk of bleeding. Understanding the manifestations of these side effects, mastering necessary precautions, and understanding their clinical efficacy are crucial to optimizing treatment options.

Side effects of defibrotide

Defibrotide may cause a variety of adverse reactions during treatment, of which circulatory and digestive system symptoms are the most common.

Circulatory system reaction

Hypotension is a more prominent side effect, usually manifesting as mild dizziness or orthostatic hypotension. In severe cases, syncope may occur. Minor bleeding events such as nosebleeds also occur from time to time and are related to the anti-thrombotic effect of the drug.

Digestive system discomfort

The incidence of diarrhea is relatively high, mostly mild to moderate. Symptoms of nausea and vomiting are usually apparent in the early stages of medication, and these reactions may be related to the direct stimulation of the gastrointestinal mucosa by the medication.

Anaphylaxis

A small number of patients may experience allergic reactions such as rash, urticaria or angioedema. In severe cases, it can lead to systemic allergic reactions, and the drug needs to be stopped immediately and corresponding treatment required.

Recognizing the typical manifestations of these side effects can help with early identification and intervention to avoid aggravation of symptoms and affecting the treatment process.

Precautions for defibrotide

The rational use of defibrotide requires strict compliance with clinical guidelines, focusing on bleeding risk management and allergic reaction monitoring.

Bleeding risk management

Defibrinoside can increase plasmin activity in vitro, which may increase the risk of bleeding. It is contraindicated in patients with active bleeding and signs of bleeding need to be closely monitored during treatment. If severe bleeding occurs, the drug should be stopped immediately and the cause treated. Wait until the bleeding stops before evaluating whether to continue treatment.

Drug interactions

Do not use it in combination with systemic anticoagulants or fibrinolytic drugs to avoid increasing the risk of bleeding. If anticoagulants are used, they should be discontinued before defibrotide treatment and restarted after the anticoagulant effect has worn off.

Monitoring of allergic reactions

During medication, patients should be closely observed for allergic symptoms such as rash, urticaria, etc. In the event of a severe allergic reaction, the drug must be permanently discontinued and treated according to standard medical protocols.

Through systematic risk management strategies, the therapeutic value of defibrotide can be maximized while reducing the incidence of clinical adverse events.

Efficacy of defibrotide

Clinical studies have confirmed that defibrotide has significant efficacy in treating VOD after HSCT, which is mainly reflected in improving survival rate and improving organ function.

Improved survival rate

Studies show that the 100-day survival rate of VOD patients treated with defibrotide is improved, and a high 100-day survival rate can still be maintained for patients with multiple organ failure associated with renal or pulmonary dysfunction.

Symptom relief

Most patients can see significant improvement in symptoms such as hepatomegaly and ascites after treatment. Data with a median follow-up of 18 months confirmed the long-term efficacy of defibrotide.

Defibrotide provides an effective treatment option for VOD patients after HSCT. Its effect in improving survival rate and symptom relief has been fully verified. Future research will further optimize its use strategy in different populations.