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cesrph09

08/18/07 2:03 AM

#4694 RE: DewDiligence #4693

As usual Dew, great info. Thanks.
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dewophile

08/18/07 3:16 PM

#4698 RE: DewDiligence #4693

"To treat DIC, you want to give something to inhibit clotting"

the conundrum is that patients with DIC are at risk of both clotting and bleeding. The clotting results in a consumptive coagulopathy which then predisposes to hemorrhage...what makes ATIII appealing imo is the wide therapeutic index as you allude to, so overshooting and exacerbating a bleeding diathesis that may result during the natural course of the illness is less apt to occur (and why the synergy of heparin and ATIII ultimately failed in kybercept)..if kybercept has taught us anything is that the benefit of combining two antithrombotic agents may very well be outweighed by the risk - APC is not heparin, so combination might ultimately work, but I wouldn't bet on it (i.e. my guess is an unacceptable risk of hemorrhage would result - just like with heparin/ATIII coadministration)