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Comparisons of argatroban to lepirudin and bivalirudin in the treatment of heparin-induced thrombocytopenia: a systematic review and meta-analysis

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Abstract

To prevent thromboembolic events associated with heparin-induced thrombocytopenia (HIT), patients usually are treated with argatroban, lepirudin, and bivalirudin. Here, we conducted a meta-analysis of studies to comparing the treatment of HIT with the following direct thrombin inhibitor: argatroban versus lepirudin and argatroban versus bivalirudin. We systematically searched PubMed, Embase, and Cochrane Library database for relevant studies. The clinical outcomes were thromboembolic complication and bleeding. A total of 589 articles were found and 9 of which were finally included in this meta-analysis. There were no significantly differences of thromboembolic complication between argatroban and hirudin analogues (lepirudin and bivalirudin) in the treatment of HIT (lepirudin: RR = 0.773, 95% CI = 0.449–1.331, P = 0.353; bivalirudin: RR = 0.768, 95% CI = 0.386–1.527, P = 0.452). Moreover, the incidence of clinical bleeding of argatroban was similar to hirudin analogues (lepirudin: RR = 0.755, 95% CI = 0.531–1.073, P = 0.117; bivalirudin: RR = 0.995, 95% CI = 0.673–1.472, P = 0.981). Current evidences show that argatroban has the similar effectiveness and safety with lepirudin and bivalirudin for defending against HIT.

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Author notes

  1. Zhengwu Sun and Xiaoyan Lan equally contributed to the work.

Authors and Affiliations

  1. Department of Pharmacy, Dalian Municipal Central Hospital, Xinan Road No. 826, Shahekou District, Dalian, 116033, China

    Zhengwu Sun & Yalin Xi

  2. Department of Neurology, Dalian Municipal Central Hospital, Dalian, China

    Xiaoyan Lan, Shen Li & Hongling Zhao

  3. Department of Pharmacology, Dalian Medical University, Dalian, China

    Zeyao Tang

Authors
  1. Zhengwu Sun
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  2. Xiaoyan Lan
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  3. Shen Li
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  4. Hongling Zhao
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  5. Zeyao Tang
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  6. Yalin Xi
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Correspondence to Yalin Xi.

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Sun, Z., Lan, X., Li, S. et al. Comparisons of argatroban to lepirudin and bivalirudin in the treatment of heparin-induced thrombocytopenia: a systematic review and meta-analysis. Int J Hematol 106, 476–483 (2017). https://doi.org/10.1007/s12185-017-2271-8

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  • DOI: https://doi.org/10.1007/s12185-017-2271-8

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