Superior outcomes with Argatroban for heparin-induced thrombocytopenia: a Bayesian network meta-analysis.
Anticoagulants
Bleeding
Heparin-induced thrombocytopenia
Mortality
Thromboembolism
Journal
International journal of clinical pharmacy
ISSN: 2210-7711
Titre abrégé: Int J Clin Pharm
Pays: Netherlands
ID NLM: 101554912
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
20
09
2020
accepted:
15
03
2021
pubmed:
29
3
2021
medline:
16
10
2021
entrez:
28
3
2021
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 33774764
doi: 10.1007/s11096-021-01260-z
pii: 10.1007/s11096-021-01260-z
pmc: PMC8352815
doi:
Substances chimiques
Anticoagulants
0
Pipecolic Acids
0
Sulfonamides
0
Heparin
9005-49-6
Arginine
94ZLA3W45F
argatroban
IY90U61Z3S
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
825-838Informations de copyright
© 2021. The Author(s).
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