Thrombotic Thrombocytopenic Purpura and Clopidogrel — A Need for New Approaches to Drug Safety

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Abstract
In this issue of the Journal, Bennett et al. describe 11 cases of thrombotic thrombocytopenic purpura that occurred in patients during or shortly after they received clopidogrel.1 The evidence linking clopidogrel to the development of thrombotic thrombocytopenic purpura is strengthened by the finding that the disorder began within 14 days after the initiation of clopidogrel therapy in all but one patient.Thrombotic thrombocytopenic purpura is known to occur in patients who are treated with ticlopidine, a similar antiplatelet drug. The similarities between ticlopidine and clopidogrel extend beyond their mechanism of action. Both drugs inhibit platelet aggregation in response to adenosine . . .