Rivaroxaban for treatment of suspected or confirmed heparin-induced thrombocytopenia study

L. A. Linkins, T. E. Warkentin, M. Pai, S. Shivakumar, R. A. Manji, P. S. Wells, C. Wu, I. Nazi, M. A. Crowther

Résultat de recherche: Articleexamen par les pairs

77 Citations (Scopus)

Résumé

Essentials Heparin-induced thrombocytopenia (HIT) is a thrombogenic condition that is difficult to treat. We evaluated rivaroxaban as a treatment option in patients with suspected or confirmed HIT. One patient had recurrent thrombosis and 9/10 patients with thrombocytopenia had platelet recovery. Rivaroxaban may be an effective and safe treatment option for HIT. Summary: Background Rivaroxaban is a direct oral anti-Xa inhibitor that has the potential to greatly simplify treatment of heparin-induced thrombocytopenia (HIT). Objectives To evaluate the efficacy and safety of rivaroxaban in this patient population, we conducted a multicenter, single-arm, prospective cohort study of patients with suspected or confirmed HIT. Patients/Methods Twenty-two consecutive adults with suspected or confirmed HIT received rivaroxaban 15 mg bid until a local HIT assay result was available. Participants with a positive local assay result continued rivaroxaban 15 mg bid until platelet recovery (or until day 21 if they had acute thrombosis at study entry), then stepped down to rivaroxaban 20 mg daily until day 30. Results and Conclusions The primary outcome measure, incidence of new symptomatic, objectively-confirmed venous and arterial thromboembolism at 30 days, occurred in one HIT-positive participant (4.5%; 95% confidence interval [CI], 0–23.5%) and one HIT-positive participant required limb amputation despite platelet recovery. Platelet recovery was achieved in nine out of 10 HIT-positive patients with thrombocytopenia. Rivaroxaban appears to be effective for treating patients with confirmed HIT, although the small number of patients enrolled limits precision.

Langue d'origineEnglish
Pages (de-à)1206-1210
Nombre de pages5
JournalJournal of Thrombosis and Haemostasis
Volume14
Numéro de publication6
DOI
Statut de publicationPublished - juin 1 2016

Note bibliographique

Publisher Copyright:
© 2016 International Society on Thrombosis and Haemostasis

ASJC Scopus Subject Areas

  • Hematology

PubMed: MeSH publication types

  • Clinical Trial, Phase III
  • Journal Article
  • Multicenter Study

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