Comparisons of argatroban to lepirudin and bivalirudin in the treatment of heparin-induced thrombocytopenia: a systematic review and meta-analysis
Systematic review published in International journal of hematology (2017)
Abstract
To prevent thromboembolic events associated with heparin-induced thrombocytopenia (HIT), patients usually are treated with argatroban, lepirudin, and bivalirudin. Here, we conducted a meta-analysis of studies to comparing the treatment of HIT with the following direct thrombin inhibitor: argatroban versus lepirudin and argatroban versus bivalirudin. We systematically searched PubMed, Embase, and Cochrane Library database for relevant studies. The clinical outcomes were thromboembolic complication and bleeding. A total of 589 articles were found and 9 of which were finally included in this meta-analysis. There were no significantly differences of thromboembolic complication between argatroban and hirudin analogues (lepirudin and bivalirudin) in the treatment of HIT (lepirudin: RR = 0.773, 95% CI = 0.449-1.331, P = 0.353; bivalirudin: RR = 0.768, 95% CI = 0.386-1.527, P = 0.452). Moreover, the incidence of clinical bleeding of argatroban was similar to hirudin analogues (lepirudin: RR = 0.755, 95% CI = 0.531-1.073, P = 0.117; bivalirudin: RR = 0.995, 95% CI = 0.673-1.472, P = 0.981). Current evidences show that argatroban has the similar effectiveness and safety with lepirudin and bivalirudin for defending against HIT.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Comparisons of argatroban to lepirudin and bivalirudin in the treatment of heparin-induced thrombocytopenia: a systematic review and meta-analysis.
Warum dies für die Hirudotherapie relevant ist
This systematic review and meta-analysis compared argatroban against lepirudin and bivalirudin—identified in the text as direct thrombin inhibitors and hirudin analogues—for the treatment of heparin-induced thrombocytopenia. Analyzing nine studies, the researchers found no significant differences between argatroban and these hirudin analogues regarding thromboembolic complications or clinical bleeding. While the abstract explicitly labels these drugs as hirudin analogues, it provides no further context regarding leeches, hirudin's natural origins, or hirudotherapy. Thus, while it touches upon agents categorized as hirudin analogues, its relevance to actual leech therapy or the broader leech secretome is indirect and limited to pharmaceutical terminology.
Zitation
Comparisons of argatroban to lepirudin and bivalirudin in the treatment of heparin-induced thrombocytopenia: a systematic review and meta-analysis
Sun Z et al. · International journal of hematology, 2017
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