Abstract
It is increasingly common in OMFS to treat patients who are taking therapeutic doses
of anticoagulant or antiplatelet drugs, or both. These patients have a high risk of
postoperative bleeding ranging from minor oozing that can be managed using local measures,
to a major haemorrhage necessitating transfusion. The risk of bleeding associated
with tyrosine kinase inhibitors (TKI) taken orally is not well-known in the specialty.
We report a case series of two patients treated with them and discuss this group of
drugs.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to British Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- United States Food and Drug Administration approved oral kinase inhibitors for the treatment of malignancies.Curr Probl Cancer. 2013; 37: 110-144
- Ibrutinib (imbruvica): a novel targeted therapy for chronic lymphocytic leukemia.P T. 2014; 39: 483-519
- Guideline for patients on antiplatelet agents undergoing elective, non-cardiac surgical intervention.2018 (Available from URL: https://www.nuh.nhs.uk/download.cfm?doc=docm93jijm4n3981.pdf&ver=6881 (last accessed 16 November 2019))
- Oral anticoagulants (VKA and NOAC): guidelines for prescribing, monitoring and management.Wirral Clinical Commissioning Group, 2015 (Available from URL: http://mm.wirral.nhs.uk/document_uploads/guidelines/AnticoagulantOralGuidelinesforprescribingmonitoringandmanagement.pdf (last accessed 16 November 2019))
Lancashire and South Cumbria Medicines Management Group. Low molecular weight heparins (LMWHs): summary prescribing guide. Available from URL: https://www.lancsmmg.nhs.uk/download/guidelines/Low-Molecular-Weigh-Heparins-Summary-Prescribing-guide-Version-1.4.pdf (last accessed 16 November 2019).
- Low molecular weight heparin (LMWH) (updated February 2019).StatPearls Publishing, 2019 (Available from URL: https://www.ncbi.nlm.nih.gov/books/NBK525957/ (last accessed 19 November 2019))
- Mechanism of action and pharmacology of unfractionated heparin.Arterioscler Thromb Vasc Biol. 2001; 21: 1094-1096
- Ticagrelor.British National Formulary (BNF) May, 2019 (Available from URL: https://bnf.nice.org.uk/drug/ticagrelor.html#indicationsAndDoses (last accessed 19 November 2019))
- Guideline on selecting appropriate non-vitamin K antagonist oral anticoagulants (NOACs)/direct oral anticoagulants (DOACs).2016 (Available from URL: https://www.sps.nhs.uk/wp-content/uploads/2018/02/Guideline-selecting-NOACs-final-Sept-2016-8s1.1.d.pdf (last accessed 19 November 2019))
- Sorafenib.British National Formulary (BNF) May, 2019 (Available from URL: https://bnf.nice.org.uk/drug/sorafenib.html (last accessed 16 November 2019))
- Effects and side effects of using sorafenib and sunitinib in the treatment of metastatic renal cell carcinoma.Int J Mol Sci. 2017; 18: 461
- Uncommon gastrointestinal bleeding during targeted therapy for advanced renal cell carcinoma: a report of four cases.Oncol Lett. 2015; 10: 2895-2898
- Management of side effects associated with sunitinib therapy for patients with renal cell carcinoma.Onco Targets Ther. 2009; 2: 51-61
- How I treat CLL patients with ibrutinib.Blood. 2018; 131: 379-386
- A phase Ib/II study evaluating activity and tolerability of BTK inhibitor PCI-32765 and of atumumab in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and related diseases.J Clin Oncol. 2012; 30 (Available from URL: https://ascopubs.org/doi/abs/10.1200/jco.2012.30.15_suppl.6508 (last accessed 25 November 2019)): 6508
- Use of anticoagulants and antiplatelet in patients with chronic lymphocytic leukaemia treated with single-agent ibrutinib.Br J Haematol. 2017; 178: 286-291
- Ibrutinib for patients with relapsed or refractory chronic lymphocytic leukaemia with 17p deletion (RESONATE-17): a phase 2, open-label, multicentre study.Lancet Oncol. 2016; 17: 1409-1418
Article info
Publication history
Published online: January 16, 2020
Identification
Copyright
Crown Copyright © 2020 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons. All rights reserved.