Fondaparinux (ARIXTRA) as an alternative anti-thrombotic prophylaxis when there is hypersensitivity to low molecular weight and unfractionated heparins.
During the last decade, new anticoagulant drugs with anti-factor-Xa properties have been described (1, 2). Among them is fondaparinux that has been licensed recently. It is a pentasaccharide mimicking the site where heparin binds to antithrombin III (1). This new drug has produced very promising clinical results in the prophylaxis of venous thrombosis after orthopedic surgery (3). Here we report two different clinical situations in which fondaparinux has yielded a successful outcome: first, a patient with repeated cutaneus reaction to several different low molecular weight heparins (LMWH), and second, a patient with severe heparin-induced thrombocytopenia (HIT). We decided to use fondaparinux in both cases since it is commercially available in Spain and mostly because the absence of in vitro cross-reaction with heparins, as discussed later.
Parody
Rocio
R
Unitat d'Hemòstasia i Trombosi. Hospital de la Santa Creu i Sant Pau. Barcelona, Spain.
Oliver
Arturo
A
Souto
Juan Carlos
JC
Fontcuberta
Jordi
J
D000028:Abortion, Induced; D058186:Acute Kidney Injury / Q000097:blood / Q000188:drug therapy / Q000628:therapy; D000230:Adenocarcinoma / Q000097:blood / Q000150:complications; D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000097:blood / Q000150:complications; D003131:Combined Modality Therapy; D003875:Drug Eruptions / Q000209:etiology; D004342:Drug Hypersensitivity; D016889:Endometrial Neoplasms / Q000097:blood / Q000150:complications; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D000077425:Fondaparinux; D006493:Heparin / Q000009:adverse effects*; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications; D011134:Polysaccharides / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy; D011247:Pregnancy; D019851:Thrombophilia / Q000188:drug therapy* / Q000209:etiology; D013927:Thrombosis / Q000517:prevention & control*
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D011134:Polysaccharides; D006493:Heparin; D000077425:Fondaparinux