PIPER Trial: Pathogen-Reduced Platelet Components Non-Inferior to Conventional Platelets for TE-AMV

October 19, 2021

Treating thrombocytopenic hematology-oncology patients with pathogen-reduced platelet components (PRPC) was non-inferior to conventional platelets for treatment-emergent assisted mechanical ventilation (TE-AMV), according to findings presented at the 2021 Virtual AABB Annual Meeting. Edward L. Snyder, MD, from Yale University Hospital, presented the findings from the Phase 4 Pathogen-Inactivated Platelets Entering Routine Practice (PIPER) study during the Plenary Oral Abstract Session held Monday evening.

In this study, Snyder and his colleagues assessed the incidence TE-AMV in thrombocytopenic adult and pediatric patients who received either PRPC (1,068 patients) or conventional platelets (1,223) The primary outcome by non-inferiority (margin of 2.3%) was the proportion of patients requiring TE-AMV via intubation or tight mask. The study had multiple secondary endpoints.

Patients who received PRPC had a lower cumulative incidence of TE-AMV compared to the conventional platelet group (2.9% versus 4.6%, respectively). Mean days to TE-AMV for patients with pulmonary dysfunction were longer for the PRPC cohort. Subgroup analysis determined that the risk for TEAMV was less common in the PRPC cohort among patients over the age of 65, men, non-white patients, patients receiving chemotherapy and patients with a history of pulmonary or cardiac disease. There was no significant difference in adverse events between the two groups.  There was a lower incidence of allergic transfusion reactions among patients who received PRPC.

Based on these findings, Snyder and his co-investigators concluded that PRPC demonstrated safety in routine clinical use with the benefit of reduced risk of transfusion-transmitted infection.