Colarossi, G, Maffulli, N ORCID: https://orcid.org/0000-0002-5327-3702, Trivellas, A, Schnöring, H, Hatam, N, Tingart, M and Migliorini, F (2021) Superior outcomes with Argatroban for heparin-induced thrombocytopenia: a Bayesian network meta-analysis. International Journal of Clinical Pharmacy.

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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.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Springer at http://doi.org/10.1007/s11096-021-01260-z - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: Anticoagulants, Bleeding, Heparin-induced thrombocytopenia, Mortality, Thromboembolism
Subjects: R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
R Medicine > RS Pharmacy and materia medica
Divisions: Faculty of Medicine and Health Sciences > School of Pharmacy and Bioengineering
Related URLs:
Depositing User: Symplectic
Date Deposited: 22 Apr 2021 08:37
Last Modified: 22 Apr 2021 08:38
URI: https://eprints.keele.ac.uk/id/eprint/9422

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