Defibrotide治疗期间可能产生什么副作用？

Defibrotide () is currently recognized as the most promising new drug for the treatment of hepatic veno-occlusive disease (HOVD) after hematopoietic stem cell transplantation (HSCT). Based on its anticoagulant, fibrinolysis-promoting, and anti-inflammatory effects, Richardson et al. first explored its application in the treatment of HVOD after HSCT. This study included 19 sHOVD patients. The dosage of Defibrotide is 5~60 mg/kg per day, intravenous infusion, and the median usage time is 15 days (2-61 days). The results showed that 42% of patients achieved complete remission (CR), and the overall survival (os) rate 100 days after transplantation reached 32%, and the patients could tolerate Defibrotide well. Since then, multiple clinical trials have confirmed the effectiveness of defibrotide in the treatment of HVOD. 

Some side effects may occur during defibrotide treatment. The most common side effects (incidence ≥10% and independent causal relationship) with defibrotide treatment are hypotension, diarrhea, vomiting, nausea and epistaxis. The incidence rate of grade 3-4 reactions related to defibrotide was 7%, mainly hypotension, pulmonary and gastrointestinal bleeding, and abdominal cramps. Only 4% of patients discontinued treatment due to side effects. In other words, the side effects of Defibrotide are usually mild, and patients do not need to worry too much.  

It is important to note that defibrotide may enhance the pharmacodynamic activity of antithrombotic/fibrinolytic drugs such as heparin or alteplase. Concomitant use of defibrotide with antithrombotic or fibrinolytic drugs is contraindicated due to an increased risk of bleeding. Do not initiate defibrotide in patients with active bleeding. Monitor patients for signs of bleeding. If a patient bleeds while taking defibrotide, discontinue defibrotide, treat the cause, and provide supportive care until bleeding has stopped.