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International Journal of Clinical Pharmacy

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01-08-2021 | Anticoagulant | Review Article

Superior outcomes with Argatroban for heparin-induced thrombocytopenia: a Bayesian network meta-analysis

Authors: Giorgia Colarossi, Nicola Maffulli, Andromahi Trivellas, Heike Schnöring, Nima Hatam, Markus Tingart, Filippo Migliorini

Published in: International Journal of Clinical Pharmacy | Issue 4/2021

Abstract

Background Argatroban, lepirudin, desirudin, bivalirudin, and danaparoid are commonly used to manage heparin-induced thrombocytopenia related complications. However, the most suitable drug for this condition still remains controversial. Aim of the review This Bayesian network meta-analysis study compared the most common anticoagulant drugs used in the management of heparin-induced thrombocytopenia. Method All clinical trials comparing two or more anticoagulant therapies for suspected or confirmed heparin-induced thrombocytopenia were considered for inclusion. Studies concerning the use of heparins or oral anticoagulants were not considered. Data concerning hospitalisation length, thromboembolic, major, and minor haemorrhagic events, and mortality rate were collected. The network analyses were made through the STATA routine for Bayesian hierarchical random-effects model analysis with standardised mean difference (SMD) and log odd ratio (LOR) effect measures. Results Data from a total of 4338 patients were analysed. The overall mean age was 62.31 ± 6.6 years old. Hospitalization length was considerably shorter in favour of the argatroban group (SMD: − 1.70). Argatroban evidenced the lowest rate of major (LOR: − 1.51) and minor (LOR: − 0.57) haemorrhagic events. Argatroban demonstrated the lowest rate of thromboembolic events (LOR: 0.62), and mortality rate (LOR: − 1.16). Conclusion Argatroban performed better overall for selected patients with HIT. Argatroban demonstrated the shortest hospitalization, and lowest rate of haemorrhages, thromboembolisms, and mortality compared to bivalirudin, lepirudin, desirudin, and danaparoid.

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Title: Superior outcomes with Argatroban for heparin-induced thrombocytopenia: a Bayesian network meta-analysis
Authors: Giorgia Colarossi
Nicola Maffulli
Andromahi Trivellas
Heike Schnöring
Nima Hatam
Markus Tingart
Filippo Migliorini
Publication date: 01-08-2021
Publisher: Springer International Publishing
Keywords: Anticoagulant
Hirudin
Heparin
Heparin-Induced Thrombocytopenia
Danaparoid
Published in: International Journal of Clinical Pharmacy / Issue 4/2021
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI: https://doi.org/10.1007/s11096-021-01260-z

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