[Refludan. First line of treatment for type II heparin-induced thrombopenia].
OBJECTIVE
To assess morbidity and mortality in patients treated with Refludan for heparin-induced thrombocytopenia type II in comparison with controls.


METHODS
One hundred thirteen patients with heparin-induced thrombocytopenia were treated with Refludan in two studies, HAT1 and HAT2. Clinical outcome was assessed in a meta analysis and compared to results in 91 control patients from a former series. Patients with no associated thrombolytic treatment were given an intravenous bolus injection of Refludan (0.4 mg/kg) then a continuous infusion of Refuldan (0.15 mg/kg/h). When a thrombolytic treatment was associated, patient were given a 0.2 mg/kg) bolus followed by a 0.10 mg/kg/h infusion.


RESULTS
The rate of thromboembolism complications, amputations and death was significantly lower in patients treated with Refludan than in controls. There was a clinically acceptable increase in episodes of bleeding with Refludan. The benefit/risk ratio was optimum for APTT between 1.5 and 3.
Camez
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D000671:Amputation, Surgical / Q000706:statistics & numerical data; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001803:Blood Transfusion; D006493:Heparin / Q000009:adverse effects*; D024764:Hirudin Therapy; D006629:Hirudins / Q000031:analogs & derivatives*; D006801:Humans; D015201:Meta-Analysis as Topic; D009503:Neutropenia / Q000139:chemically induced* / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use; D013923:Thromboembolism / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control
D000925:Anticoagulants; D006629:Hirudins; D011994:Recombinant Proteins; D006493:Heparin; C083544:lepirudin
Refludan. Le premier traitement de la thrombopénie induite par l'héparine (TIH) de type II.