Fondaparinux for the treatment of acute heparin-induced thrombocytopenia: a single-center experience.

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Grouzi E, Kyriakou E, Panagou I, Spiliotopoulou I

Fondaparinux for the treatment of acute heparin-induced thrombocytopenia: a single-center experience.

Clin Appl Thromb Hemost. 2010 Dec;16(6):663-7. doi: 10.1177/1076029609347900. Epub 2009 Oct 13.

PubMed ID
19825921 [ View in PubMed
]
Abstract

Heparin-induced thrombocytopenia (HIT) is a life-threatening immune response to heparin that is associated with a high risk of thromboembolic complications. The syndrome is caused by antibodies that are reactive against complexes of platelet factor 4/heparin (PF4/H). For patients with HIT, the discontinuation of heparin alone is not sufficient and the diagnosis necessitates the administration of an alternative anticoagulant. Fondaparinux is a synthetic pentasaccharide that binds to antithrombin and potentiates inhibition of factor Xa. Data have shown that fondaparinux is structurally too short to induce an antibody response and could be a useful agent to treat HIT. In our hospital, we retrospectively analyzed the use of fondaparinux in the treatment of 24 patients with acute HIT during unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) administration and compared the results to a similar population of 20 patients who were treated with lepirudin. The treated patients had a complete platelet count recovery, and none experienced a new thromboembolic complication or major bleeding. The development of limb gangrene (2 patients who received lepirudin and 1 who received fondaparinux) likely resulted from a delay in diagnosis and treatment initiation. Our data suggest that fondaparinux may be considered a safe and an effective alternative treatment in HIT complicated with or without thrombosis.

DrugBank Data that Cites this Article

Drugs
Drug Targets
DrugTargetKindOrganismPharmacological ActionActions
FondaparinuxCoagulation factor XProteinHumans
Yes
Inhibitor
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