Abciximab readministration

The IIb/IIIa receptor inhibitors have been shown to improve outcomes following percutaneous coronary intervention (PCI), particularly by decreasing periprocedural myocardial necrosis. Abciximab has been subject to multiple studies, demonstrating consistent improved early and late outcomes in multiple patient populations, including a mortality advantage in diabetics, but there has been concern about the possibility of anaphylaxis, thrombocytopenia, and reduced clinical efficacy with repeat administration of abciximab. Results of the ReoPro Readministration Registry, a prospective, phase IV, multicenter registry of 500 patients undergoing PCI who were treated with abciximab at least 7 days after a previous treatment with this same drug, support the contention that abciximab readministration is both safe and clinically efficacious and that there is no significant increase in the incidence of thrombocytopenia as compared with historical controls of trials of first abciximab administration. However, profound thrombocytopenia did occur with increased frequency as compared with historical controls, suggesting a shift from mild to profound thrombocytopenia with abciximab readministration.