Caplacizumab for pediatric immune thrombotic thrombocytopenic Purpura: A scoping review of current evidence

<p>While caplacizumab, a von Willebrand factor inhibitor, has dramatically improved iTTP management in adults, its role in pediatric iTTP remains understudied. This scoping review synthesizes current evidence on the safety and efficacy of caplacizumab in children with iTTP. We conducted a syst...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Abdulrahman F. Al-Mashdali (17148316) (author)
مؤلفون آخرون: Samah M. Salih (21837866) (author), Priyadarshini Asmita Vatsyayan (21837869) (author), Deena Mudawi (16441978) (author), Sarah A. Elkourashy (21632903) (author), Honar Cherif (17746722) (author), Shehab F. Mohamed (17945561) (author)
منشور في: 2025
الموضوعات:
الوسوم: إضافة وسم
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author Abdulrahman F. Al-Mashdali (17148316)
author2 Samah M. Salih (21837866)
Priyadarshini Asmita Vatsyayan (21837869)
Deena Mudawi (16441978)
Sarah A. Elkourashy (21632903)
Honar Cherif (17746722)
Shehab F. Mohamed (17945561)
author2_role author
author
author
author
author
author
author_facet Abdulrahman F. Al-Mashdali (17148316)
Samah M. Salih (21837866)
Priyadarshini Asmita Vatsyayan (21837869)
Deena Mudawi (16441978)
Sarah A. Elkourashy (21632903)
Honar Cherif (17746722)
Shehab F. Mohamed (17945561)
author_role author
dc.creator.none.fl_str_mv Abdulrahman F. Al-Mashdali (17148316)
Samah M. Salih (21837866)
Priyadarshini Asmita Vatsyayan (21837869)
Deena Mudawi (16441978)
Sarah A. Elkourashy (21632903)
Honar Cherif (17746722)
Shehab F. Mohamed (17945561)
dc.date.none.fl_str_mv 2025-07-29T09:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.blre.2025.101326
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Caplacizumab_for_pediatric_immune_thrombotic_thrombocytopenic_Purpura_A_scoping_review_of_current_evidence/29712158
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Immunology
Paediatrics
Pharmacology and pharmaceutical sciences
Caplacizumab
Pediatric
Children
Thrombotic thrombocytopenic purpurai
TTP
dc.title.none.fl_str_mv Caplacizumab for pediatric immune thrombotic thrombocytopenic Purpura: A scoping review of current evidence
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p>While caplacizumab, a von Willebrand factor inhibitor, has dramatically improved iTTP management in adults, its role in pediatric iTTP remains understudied. This scoping review synthesizes current evidence on the safety and efficacy of caplacizumab in children with iTTP. We conducted a systematic literature search (PubMed, Scopus) up to March 2025, identifying 15 studies (36 patients) meeting inclusion criteria. The cohort (median age 14 years, range 1–17) exhibited female predominance (72 %) and diverse ethnic backgrounds. Neurological symptoms (53 %) and bleeding manifestations (petechiae, purpura, or ecchymoses in 74 %) were common presentations. Caplacizumab was administered at 5 mg (17 %), 10 mg (75 %), or 11 mg (8 %), alongside plasma exchange (22 % received >10 sessions) and immunosuppression (97 % corticosteroids, 92 % rituximab). Key outcomes included rapid platelet recovery (median 3.5 days post-caplacizumab initiation) and relatively short hospitalization (median 14 days). Adverse events were uncommon (11 % minor bleeding), with no major or life-threatening hemorrhagic complications reported. Mortality was 0 %, with all patients surviving to follow-up. During a median follow-up period of 6–12 months, 94 % of patients remained relapse-free. Notably, 22 % of patients were under 12 years of age, underscoring the off-label use of caplacizumab in younger children. These findings suggest caplacizumab is effective and safe in pediatric iTTP, mirroring outcomes observed in adults while demonstrating a favorable bleeding profile. However, variability in dosing and limited data on long-term effects highlight the need for pediatric-specific guidelines and prospective studies. This review supports caplacizumab as a promising adjunct in childhood iTTP but calls for further research to optimize its use in this vulnerable population.</p><h2>Other Information</h2> <p> Published in: Blood Reviews<br> License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.blre.2025.101326" target="_blank">https://dx.doi.org/10.1016/j.blre.2025.101326</a></p>
eu_rights_str_mv openAccess
id Manara2_1f85fb279bdd76a48eb7e3f75dc941d7
identifier_str_mv 10.1016/j.blre.2025.101326
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/29712158
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spelling Caplacizumab for pediatric immune thrombotic thrombocytopenic Purpura: A scoping review of current evidenceAbdulrahman F. Al-Mashdali (17148316)Samah M. Salih (21837866)Priyadarshini Asmita Vatsyayan (21837869)Deena Mudawi (16441978)Sarah A. Elkourashy (21632903)Honar Cherif (17746722)Shehab F. Mohamed (17945561)Biomedical and clinical sciencesImmunologyPaediatricsPharmacology and pharmaceutical sciencesCaplacizumabPediatricChildrenThrombotic thrombocytopenic purpuraiTTP<p>While caplacizumab, a von Willebrand factor inhibitor, has dramatically improved iTTP management in adults, its role in pediatric iTTP remains understudied. This scoping review synthesizes current evidence on the safety and efficacy of caplacizumab in children with iTTP. We conducted a systematic literature search (PubMed, Scopus) up to March 2025, identifying 15 studies (36 patients) meeting inclusion criteria. The cohort (median age 14 years, range 1–17) exhibited female predominance (72 %) and diverse ethnic backgrounds. Neurological symptoms (53 %) and bleeding manifestations (petechiae, purpura, or ecchymoses in 74 %) were common presentations. Caplacizumab was administered at 5 mg (17 %), 10 mg (75 %), or 11 mg (8 %), alongside plasma exchange (22 % received >10 sessions) and immunosuppression (97 % corticosteroids, 92 % rituximab). Key outcomes included rapid platelet recovery (median 3.5 days post-caplacizumab initiation) and relatively short hospitalization (median 14 days). Adverse events were uncommon (11 % minor bleeding), with no major or life-threatening hemorrhagic complications reported. Mortality was 0 %, with all patients surviving to follow-up. During a median follow-up period of 6–12 months, 94 % of patients remained relapse-free. Notably, 22 % of patients were under 12 years of age, underscoring the off-label use of caplacizumab in younger children. These findings suggest caplacizumab is effective and safe in pediatric iTTP, mirroring outcomes observed in adults while demonstrating a favorable bleeding profile. However, variability in dosing and limited data on long-term effects highlight the need for pediatric-specific guidelines and prospective studies. This review supports caplacizumab as a promising adjunct in childhood iTTP but calls for further research to optimize its use in this vulnerable population.</p><h2>Other Information</h2> <p> Published in: Blood Reviews<br> License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.blre.2025.101326" target="_blank">https://dx.doi.org/10.1016/j.blre.2025.101326</a></p>2025-07-29T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.blre.2025.101326https://figshare.com/articles/journal_contribution/Caplacizumab_for_pediatric_immune_thrombotic_thrombocytopenic_Purpura_A_scoping_review_of_current_evidence/29712158CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/297121582025-07-29T09:00:00Z
spellingShingle Caplacizumab for pediatric immune thrombotic thrombocytopenic Purpura: A scoping review of current evidence
Abdulrahman F. Al-Mashdali (17148316)
Biomedical and clinical sciences
Immunology
Paediatrics
Pharmacology and pharmaceutical sciences
Caplacizumab
Pediatric
Children
Thrombotic thrombocytopenic purpurai
TTP
status_str publishedVersion
title Caplacizumab for pediatric immune thrombotic thrombocytopenic Purpura: A scoping review of current evidence
title_full Caplacizumab for pediatric immune thrombotic thrombocytopenic Purpura: A scoping review of current evidence
title_fullStr Caplacizumab for pediatric immune thrombotic thrombocytopenic Purpura: A scoping review of current evidence
title_full_unstemmed Caplacizumab for pediatric immune thrombotic thrombocytopenic Purpura: A scoping review of current evidence
title_short Caplacizumab for pediatric immune thrombotic thrombocytopenic Purpura: A scoping review of current evidence
title_sort Caplacizumab for pediatric immune thrombotic thrombocytopenic Purpura: A scoping review of current evidence
topic Biomedical and clinical sciences
Immunology
Paediatrics
Pharmacology and pharmaceutical sciences
Caplacizumab
Pediatric
Children
Thrombotic thrombocytopenic purpurai
TTP