Artikel
Use of Fondaparinux for long term prophylaxis in high risk patients with history of HIT (heparin-induced thrombocytopenia)
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Autoren
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G. Grellmann
- Bavaria Klinik, Kreischa
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F. Oehmichen
- Bavaria Klinik, Kreischa
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M. Pohl
- Bavaria Klinik, Kreischa
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J. Hankowitz
- Gesundheit + Medizin, München
| Veröffentlicht: | 12. November 2007 |
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Gliederung
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Context: Heparin-induced thrombocytopenia (HIT) is an antibody-mediated severe complication caused by heparin. Fondaparinux is a new synthetic factor Xa inhibitor (molecular weight: 1.726 Dalton) with superior efficacy-/safety-profile compared to low molecular weight heparins (LMWH) and exerts in vitro no cross-reactivity with HIT-antibodies. So far, there is a lack of clinical studies where Fondaparinux is used for the management of acute HIT and in patients with history of HIT.
Aim of the study: Although Fondaparinux is not approved for the management of acute HIT syndrome, we report cases where Fondaparinux is used in-label for prevention of venous thromboembolism in high risk patients with history of HIT.
Material and method: Six patients with history of HIT receive fondaparinux 2.5 mg once daily s.c. for prevention of venous thromboembolism as long as the risk of thromboembolism persists.
Results: In six patients with a history of HIT Fondaparinux was successfully used for the prevention of venous thromboembolism in high risk patients: No HIT, venous thromboembolic events or bleedings were observed.
Conclusion: Due to its superior efficacy-/safety profile compared to LMWH Fondaparinux might be also a useful drug in the management of HIT. In patients with a history of HIT Fondaparinux seems to be effective and safe; however, controlled clinical trials are necessary to confirm our observations.
