International Journal of Hematology

, Volume 106, Issue 4, pp 476–483 | Cite as

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

  • Zhengwu Sun
  • Xiaoyan Lan
  • Shen Li
  • Hongling Zhao
  • Zeyao Tang
  • Yalin Xi
Review Article


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.


Argatroban Lepirudin Bivalirudin Heparin-induced thrombocytopenia Meta-analysis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Japanese Society of Hematology 2017

Authors and Affiliations

  • Zhengwu Sun
    • 1
  • Xiaoyan Lan
    • 2
  • Shen Li
    • 2
  • Hongling Zhao
    • 2
  • Zeyao Tang
    • 3
  • Yalin Xi
    • 1
  1. 1.Department of PharmacyDalian Municipal Central HospitalDalianChina
  2. 2.Department of NeurologyDalian Municipal Central HospitalDalianChina
  3. 3.Department of PharmacologyDalian Medical UniversityDalianChina

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