title: A comparison of lepirudin and argatroban outcomes.
abstract: Although both argatroban and lepirudin are used for the management of heparin-induced thrombocytopenia (HIT), data comparing these agents are lacking. The objective of this project was to compare the clinical outcomes of lepirudin vs argatroban therapy. Patients who received a direct thrombin inhibitor (DTI) from January 2000 to December 2001 were identified. Medical charts were retrospectively reviewed and relevant data extracted. The primary efficacy outcome was effective anticoagulation and the primary safety outcome was major bleeding. Data were analyzed using the t test and Fisher's exact test. Sixty-one lepirudin patients and 29 argatroban patients received a DTI during the study period. A new diagnosis of HIT was the indication for DTI therapy in 44.8% of argatroban patients and 57.4% of lepirudin patients. Effective anticoagulation was achieved in 77.8% of argatroban patients and 69.5% of lepirudin patients (p = .61). Major bleeding occurred in 10.3% and 11.5% of argatroban and lepirudin patients, respectively (p = 1.0). Argatroban and lepirudin demonstrated comparable safety and efficacy outcomes.
authors.affiliation: William Beaumont Hospital, Royal Oak, Michigan; Wayne State University, Detroit, Michigan 48073, USA. msmythe@beaumont.edu
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Smythe
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Stephens
authors.forename: John M
authors.initials: JM
authors.lastname: Koerber
authors.forename: Joan C
authors.initials: JC
authors.lastname: Mattson
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001120:Arginine / Q000031:analogs & derivatives; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy; D006629:Hirudins; D006801:Humans; D008297:Male; D010875:Pipecolic Acids / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D013449:Sulfonamides; D013917:Thrombin / Q000037:antagonists & inhibitors / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D010875:Pipecolic Acids; D011994:Recombinant Proteins; D013449:Sulfonamides; D001120:Arginine; D013917:Thrombin; C031942:argatroban; C083544:lepirudin