[Thrombopenia induced by heparin: treatment with Org 10172. Tolerability and efficacy].
OBJECTIVE
Heparin-induced thrombocytopenia is a relatively common and potentially serious adverse complication of heparin treatment. After heparin withdrawal initiation of an alternative anticoagulant is often indicated. Org 10172 or Orgaran is a mixture of several non-heparin low molecular weight glycosaminoglycans with proven antithrombotic efficacy. Unlike low molecular weight heparins, Org 10172 has a low cross reaction rate (about 10%) with the heparin-dependent antibody.


METHODS
We present nine patients with heparin induced thrombocytopenia. Org 10172 was prescribed to treat or to prevent a thromboembolic event.


RESULTS
Seven patients required further parenteral anticoagulant at diagnosis of heparin-induced thrombocytopenia. Org 10172 was given at prophylactic doses for three patients with a high thrombosis risk and at therapeutic doses for four patients who presented either a venous or an arterial thrombosis related to thrombocytopenia. Two patients presented heparin-induced thrombocytopenia four to six years earlier and needed a parenteral anticoagulation treatment in a post-operative period.


CONCLUSIONS
For the nine patients, Org 10172 was a safe and effective antithrombotic treatment. However, strict monotoring of the platelet count is absolutely mandatory during Org 10172 therapy.
Tardy-Poncet
B
B
Département d'Hématologie, Hôpital Nord, CHRU de Saint-Etienne.
Reynaud
J
J
Tardy
B
B
Mahul
P
P
Mismetti
P
P
Beraud
A M
AM
Rebaud
M A
MA
Bayon
M
M
Guyotat
D
D
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002809:Chondroitin Sulfates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003871:Dermatan Sulfate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006497:Heparan Sulfate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy; D013923:Thromboembolism / Q000188:drug therapy* / Q000517:prevention & control; D013997:Time Factors
D000925:Anticoagulants; D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D006493:Heparin; D006497:Heparan Sulfate; C035838:danaparoid
Thrombopénie induite par l'héparine: traitement par l'ORG 10172. Tolérance et efficacité.