Argatroban: a review of its use in the management of heparin-induced thrombocytopenia.
Review published in American journal of cardiovascular drugs : drugs, devices, and other interventions (2009)
Abstract
Argatroban, a highly selective direct thrombin inhibitor, is indicated for use as an anticoagulant for the treatment and prophylaxis of thrombosis in patients with heparin-induced thrombocytopenia (HIT), and in patients undergoing percutaneous coronary intervention (PCI) who have, or are at risk for, HIT. Intravenous argatroban improved clinical outcomes and was generally well tolerated in adults with HIT or HIT with thrombosis syndrome (HITTS). In two pivotal, open-label, historically controlled studies in adults with HIT, the incidence of the primary composite endpoint (all-cause death, all-cause amputation, or new thrombosis) was significantly lower in argatroban recipients than in historical controls, and more argatroban recipients than historical controls stayed event-free during the study according to a Kaplan-Meier analysis. In adults with HITTS in these trials, although the incidence of the primary composite endpoint did not differ significantly between argatroban recipients and historical controls, a Kaplan-Meier analysis showed that more patients receiving argatroban than historical controls remained event-free during the study. Major and minor bleeding rates in argatroban recipients were generally similar to those in historical controls in these studies. Argatroban was also an effective anticoagulant in patients with HIT undergoing PCI in three small, uncontrolled trials, pooled data from which showed that most (>or=95%) patients achieved a satisfactory outcome of the PCI procedure and adequate anticoagulation (coprimary endpoints). It was generally well tolerated in these patients, with the incidence of major bleeding being <or=1.1%. The efficacy and safety of argatroban in pediatric patients has not been established. However, a small uncontrolled, preliminary study suggests that it may be useful in seriously ill pediatric patients requiring nonheparin anticoagulation.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Argatroban, a highly selective direct thrombin inhibitor, is indicated for use as an anticoagulant for the treatment and prophylaxis of thrombosis in patients with heparin-induced thrombocytopenia (HIT), and in patients undergoing percutaneous coronary intervention (PCI) who have, or are at risk...
Warum dies für die Hirudotherapie relevant ist
Diese Übersichtsarbeit untersucht den Einsatz von Argatroban, einem hochselektiven direkten Thrombininhibitor, als Antikoagulans bei Patienten mit heparininduzierter Thrombozytopenie (HIT) sowie bei Patienten, die sich einer perkutanen Koronarintervention unterziehen. Sie hebt die klinischen Ergebnisse hervor und stellt eine verbesserte ereignisfreie Überlebensrate sowie im Allgemeinen ähnliche Blutungsraten im Vergleich zu historischen Kontrollen fest. Für die American Society of Hirudotherapy stellt Argatroban eine wichtige pharmakologische Parallele zu Hirudin dar, dem potenten direkten Thrombininhibitor, der natürlicherweise im Blutegelspeichel vorkommt. Das Verständnis des klinischen Managements, der Wirksamkeit und der Blutungsrisiken synthetischer direkter Thrombininhibitoren liefert einen wesentlichen Kontext für Forscher, die aus Blutegeln gewonnene Antikoagulanzien untersuchen. Allerdings weist dieser Artikel nur eine indirekte Relevanz auf, da er sich vollständig auf ein synthetisches Arzneimittel konzentriert; es werden weder Blutegel, Blutegelextrakte noch Hirudin in den diskutierten Studien erwähnt oder verwendet.
Zitation
Argatroban: a review of its use in the management of heparin-induced thrombocytopenia.
Dhillon · American journal of cardiovascular drugs : drugs, devices, and other interventions, 2009
Verwandter klinischer Kontext
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