Argatroban Versus Bivalirudin in the Treatment of Suspected or Confirmed Heparin-Induced Thrombocytopenia

• Published in: Journal of pharmacy practice Vol. 34; no. 4; p. 529
• Main Authors: Duewell, Brittney E, Briski, Matthew J, Feih, Joel T, Rinka, Joseph R G, Tawil, Justin N
• Format: Journal Article
• Language: English
• Published: United States 01.08.2021
• Subjects: Anticoagulants; Arginine - analogs & derivatives; Heparin; Hirudins; Humans; Peptide Fragments; Pipecolic Acids; Recombinant Proteins; Retrospective Studies; Sulfonamides; Thrombocytopenia; Treatment Outcome; direct thrombin inhibitor; bivalirudin; argatroban; anticoagulation; heparin-induced thrombocytopenia
• ISSN: 1531-1937
• DOI: 10.1177/0897190019882866

Argatroban and bivalirudin are direct thrombin inhibitors (DTIs) used for the treatment of heparin-induced thrombocytopenia (HIT). The purpose of this study was to determine whether either agent offered an advantage in efficacy and ability to remain within the targeted therapeutic anticoagulation range. This was a single-center, retrospective, observational cohort study at a large academic medical center. The primary efficacy outcome was time to therapeutic anticoagulation, defined as total number of hours to achieve 2 consecutive activated partial thromboplastin time (aPTT) values in goal range. A total of 91 patients were included in the analysis. Average time to initial therapeutic anticoagulation was 4.71 hours and 9.8 hours for the argatroban and bivalirudin groups, respectively ( < .01). Argatroban may be advantageous compared to bivalirudin in achieving initial therapeutic anticoagulation goals among patients with suspected or confirmed HIT.