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.
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Resumen
Comparisons of argatroban to lepirudin and bivalirudin in the treatment of heparin-induced thrombocytopenia: a systematic review and meta-analysis.
Por qué esto importa para la hirudoterapia
Esta revisión sistemática y metaanálisis comparó argatroban frente a lepirudina y bivalirudina—identificados en el texto como inhibidores directos de la trombina y análogos de la hirudina—para el tratamiento de la trombocitopenia inducida por heparina. Analizando nueve estudios, los investigadores no encontraron diferencias significativas entre argatroban y estos análogos de la hirudina con respecto a complicaciones tromboembólicas o sangrado clínico. Aunque el resumen etiqueta explícitamente a estos fármacos como análogos de la hirudina, no proporciona más contexto sobre las sanguijuelas, el origen natural de la hirudina ni la hirudoterapia. Así, si bien aborda agentes categorizados como análogos de la hirudina, su relevancia para la terapia real con sanguijuelas o para el secretoma más amplio de las sanguijuelas es indirecta y se limita a la terminología farmacéutica.
Citación
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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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026