Recombinant hirudin, a new anticoagulant, has no effect on faecal blood loss.
Hirudin is a selective thrombin inhibitor with strong anticoagulant properties which could elicit gastro-intestinal bleeding. A double-blind cross-over study of the effects of hirudin on gastro-intestinal bleeding was therefore conducted on 12 healthy, consenting males. After labelling erythrocytes with 51Cr and returning them intravenously, stools were collected for 2 days to measure radioactivity and hence baseline faecal blood loss. After injection of hirudin or placebo stools were collected for 3 days. Partial thromboplastin time was measured sequentially after medication with hirudin or placebo. This procedure was repeated after injection of the alternate medication 1 week later. Hirudin was tolerated well. Mean faecal blood loss associated with hirudin was slightly higher than with placebo (1.63 ml vs 1.15 ml over 3 days; 95% confidence interval for the difference between hirudin and placebo was -0.68 to 1.63) but these differences are clinically irrelevant. After hirudin injection PTT was elevated to about twice the baseline values but returned to baseline within 12 h after the last hirudin injection.
Meyer
B H
BH
Department of Pharmacology, University of the Orange Free State, Bloemfontein, Republic of South Africa.
Luus
H G
HG
Muller
F O
FO
Badenhorst
P N
PN
Lotter
M G
MG
Röthig
H J
HJ
Grötsch
H
H
Rosenkranz
B
B
D000293:Adolescent; D000328:Adult; D004311:Double-Blind Method; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006629:Hirudins / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009780:Occult Blood; D010314:Partial Thromboplastin Time; D013917:Thrombin / Q000037:antagonists & inhibitors
D006629:Hirudins; D013917:Thrombin