Argatroban Versus Bivalirudin in the Treatment of Suspected or Confirmed Heparin-Induced Thrombocytopenia

Background: Argatroban and bivalirudin are direct thrombin inhibitors (DTIs) used for the treatment of heparin-induced thrombocytopenia (HIT). The purpose of this study was to determine whether either agent offered an advantage in efficacy and ability to remain within the targeted therapeutic antico...

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Bibliographic Details
Published in:Journal of pharmacy practice 2021-08, Vol.34 (4), p.529-534
Main Authors: Duewell, Brittney E., Briski, Matthew J., Feih, Joel T., Rinka, Joseph R. G., Tawil, Justin N.
Format: Article
Language:English
Subjects:
Anticoagulants
Arginine - analogs & derivatives
Heparin
Hirudins
Humans
Peptide Fragments
Pipecolic Acids
Recombinant Proteins
Retrospective Studies
Sulfonamides
Thrombocytopenia
Treatment Outcome
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Summary:Background: Argatroban and bivalirudin are direct thrombin inhibitors (DTIs) used for the treatment of heparin-induced thrombocytopenia (HIT). The purpose of this study was to determine whether either agent offered an advantage in efficacy and ability to remain within the targeted therapeutic anticoagulation range. Methods: This was a single-center, retrospective, observational cohort study at a large academic medical center. The primary efficacy outcome was time to therapeutic anticoagulation, defined as total number of hours to achieve 2 consecutive activated partial thromboplastin time (aPTT) values in goal range. Results: A total of 91 patients were included in the analysis. Average time to initial therapeutic anticoagulation was 4.71 hours and 9.8 hours for the argatroban and bivalirudin groups, respectively (P < .01). Conclusions: Argatroban may be advantageous compared to bivalirudin in achieving initial therapeutic anticoagulation goals among patients with suspected or confirmed HIT.
ISSN:0897-1900
1531-1937
DOI:10.1177/0897190019882866