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Chen and colleagues¹ recently reviewed 10 published case reports and described 3 new cases of ticlopidine-associated thrombotic thrombocytopenic purpura (TTP). In this communication we document the spontaneous reports of adverse drug reactions associated with ticlopidine, focusing attention on TTP, by analysis of a regional database of all the spontaneous reports sent in by physicians from the Italian Veneto and Lombardy regions. These 2 regions (13.7 million inhabitants) are the principal contributors to the Italian spontaneous reporting system (about 50% of all Italian reports), and their 1998 annual reporting rate was 202 per million inhabitants.

In Italy, ticlopidine has been available since 1981 and is currently widely used (75.7 packages per 1000 inhabitants in 1998). From 1993 to 1998, 113 reports of ticlopidine-associated adverse drug reactions were documented, 49 referring to suspected hematological reactions (20 cases of leukopenia or neutropenia; 7 cases of agranulocytosis; 7 hemorrhagic disorders; 6 cases of thrombocytopenia; . . . [Full Text of this Article]

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