PMID- 16788093
OWN - NLM
STAT- MEDLINE
DCOM- 20070221
LR  - 20220321
IS  - 1060-0280 (Print)
IS  - 1060-0280 (Linking)
VI  - 40
IP  - 7-8
DP  - 2006 Jul-Aug
TI  - Fondaparinux for thromboembolic treatment and prophylaxis of heparin-induced 
      thrombocytopenia.
PG  - 1383-7
AB  - OBJECTIVE: To review literature evaluating the use of fondaparinux for 
      thromboembolic treatment and prophylaxis in patients with heparin-induced 
      thrombocytopenia (HIT). DATA SOURCES: A MEDLINE search (1966-February 2006) was 
      conducted using the search terms fondaparinux, heparin, low-molecular-weight 
      heparin, and thrombocytopenia to identify English-language articles. Additional 
      sources were identified from bibliographies of select articles and the 
      manufacturer. DATA SYNTHESIS: Fondaparinux, a pentasaccharide that selectively 
      inhibits factor Xa, has been reported to have negligible or no cross-reactivity 
      in vitro with HIT antibodies. Thromboembolic treatment and prophylaxis with 
      fondaparinux in patients with HIT has been described. Three cases reported 
      patients who were successfully treated for thromboembolic events with 
      fondaparinux after developing HIT during therapy with unfractionated heparin 
      (UFH) or low-molecular-weight heparin (LMWH). Another report showed positive 
      outcomes using fondaparinux for prophylaxis in a patient who had previously 
      developed HIT after receiving UFH. Moreover, 2 case series, one using 
      fondaparinux for prophylaxis in patients with a previous diagnosis of HIT and the 
      other using fondaparinux for treatment in patients who developed HIT while 
      receiving UFH or LMWH, reported normal platelet counts during fondaparinux 
      treatment. Finally, results of a retrospective review demonstrated that 
      fondaparinux prevented thromboembolic events or recurrent thrombocytopenia in 
      patients with a prior HIT diagnosis. CONCLUSIONS: Limited data support the use of 
      fondaparinux for thromboembolic treatment or prophylaxis in patients with 
      antibody assay-confirmed HIT who do not have a contraindication for fondaparinux 
      use. Randomized controlled trials have not been published; therefore, questions 
      remain regarding efficacy, safety, optimal doses, treatment duration, and 
      incidence of thromboembolic events when fondaparinux is used in this setting. 
      Prospective trials evaluating the efficacy and safety of fondaparinux in this 
      patient population need to be conducted to answer these questions.
FAU - Efird, Leigh E
AU  - Efird LE
AD  - Virginia Commonwealth University Medical Center/Medical College of Virginia 
      Hospitals, Richmond, 23298, USA. lefird@mcvh-vcu.edu
FAU - Kockler, Denise R
AU  - Kockler DR
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20060620
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Anticoagulants)
RN  - 0 (Polysaccharides)
RN  - 9005-49-6 (Heparin)
RN  - J177FOW5JL (Fondaparinux)
SB  - IM
MH  - Anticoagulants/*therapeutic use
MH  - Fondaparinux
MH  - Heparin/adverse effects
MH  - Humans
MH  - Polysaccharides/*therapeutic use
MH  - Thrombocytopenia/chemically induced/*drug therapy
MH  - Thromboembolism/drug therapy/prevention & control
RF  - 34
EDAT- 2006/06/22 09:00
MHDA- 2007/02/22 09:00
CRDT- 2006/06/22 09:00
PHST- 2006/06/22 09:00 [pubmed]
PHST- 2007/02/22 09:00 [medline]
PHST- 2006/06/22 09:00 [entrez]
AID - aph.1G738 [pii]
AID - 10.1345/aph.1G738 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2006 Jul-Aug;40(7-8):1383-7. doi: 10.1345/aph.1G738. Epub 2006 
      Jun 20.