The direct thrombin inhibitor argatroban: a review of its use in patients with and without HIT.
Argatroban is a synthetic direct thrombin inhibitor with a relative short elimination half-life of 45 minutes and elimination which is predominantly performed via hepatic metabolism. Argatroban anticoagulation has been systematically studied in patients exhibiting the heparin-induced thrombocytopenia (HIT)/thrombosis syndrome and demonstrated to be a safe and effective therapy in this indication. Moreover, in smaller studies argatroban has also been assessed in special clinical settings in non-HIT patients. The current review presents the pharmacology of argatroban, data regarding monitoring of the agent, and an overview of the results of the major clinical trials assessing argatroban anticoagulation in HIT patients. Additionally, data from clinical trials with argatroban use outside HIT, in more special indications such as in percutaneous coronary intervention, stroke, renal replacement therapy, and intensive care medicine, are reviewed.
Koster
Andreas
A
Department of Anesthesia, Deutsches Herzzentrum Berlin, Germany.
Fischer
Karl-Georg
KG
Harder
Sebastian
S
Mertzlufft
Fritz
F
N Engl J Med. 2005 Sep 8;353(10):1028-40
16148288
Ann Pharmacother. 2003 May;37(5):652-4
12708939
J Thromb Thrombolysis. 2004 Aug;18(1):31-7
15744551
Ann Pharmacother. 2003 Sep;37(9):1237-40
12921506
Circulation. 1999 Aug 10;100(6):587-93
10441094
Catheter Cardiovasc Interv. 2002 Oct;57(2):177-84
12357516
Am Heart J. 2006 Jun;151(6):1131-8
16781211
N Engl J Med. 2006 Nov 23;355(21):2203-16
17124018
Pharmacotherapy. 2000 Mar;20(3):318-29
10730687
Clin Appl Thromb Hemost. 2005 Jul;11(3):279-87
16015413
Arch Neurol. 2006 Aug;63(8):1057-62
16908730
Eur J Haematol. 2007 Feb;78(2):161-6
17328717
Blood Coagul Fibrinolysis. 2005 Jun;16(4):251-7
15870544
J Invasive Cardiol. 2003 Nov;15(11):611-6
14608128
JAMA. 2003 Feb 19;289(7):853-63
12588269
J Thromb Thrombolysis. 2005 Jun;19(3):183-8
16082605
Thromb Haemost. 1994 Sep;72(3):381-6
7855788
Am J Health Syst Pharm. 2002 Nov 1;59(21):2078-83
12434720
J Thromb Thrombolysis. 2006 Dec;22(3):169-76
17103051
J Thorac Cardiovasc Surg. 2006 Sep;132(3):699-700
16935137
Thromb Haemost. 2005 Nov;94(5):958-64
16363236
Pharmacotherapy. 2004 Mar;24(3):409-14
15040656
Circulation. 2004 Nov 2;110(18):e454-8
15520327
Thromb Haemost. 2004 Jun;91(6):1137-45
15175800
Circulation. 1999 Jan 5-12;99(1):73-80
9884382
Semin Thromb Hemost. 2004 Jun;30(3):273-83
15282649
Nephrol Dial Transplant. 1995 Nov;10(11):2137-40
8643186
Kidney Int. 2004 Dec;66(6):2446-53
15569338
Stroke. 2004 Jul;35(7):1677-82
15155959
Ann Pharmacother. 2007 May;41(5):749-54
17440009
Am J Health Syst Pharm. 2002 Jul 1;59(13):1258-66
12116891
Ann Pharmacother. 2005 Oct;39(10):1601-5
16131539
Ann Pharmacother. 2004 Jan;38(1):25-9
14742788
J Clin Pharmacol. 1999 May;39(5):513-9
10234600
Ann Pharmacother. 2005 Feb;39(2):231-6
15632219
Chest. 2006 May;129(5):1167-75
16685006
Arch Intern Med. 2003 Aug 11-25;163(15):1849-56
12912723
Circulation. 2001 Apr 10;103(14):1838-43
11294800
Lancet. 2002 Jan 26;359(9303):294-302
11830196
J Am Coll Cardiol. 1999 Jun;33(7):1879-85
10362188
Chest. 2005 Feb;127(2 Suppl):27S-34S
15706028