PMID- 28294347
OWN - NLM
STAT- MEDLINE
DCOM- 20180322
LR  - 20180322
IS  - 1600-0536 (Electronic)
IS  - 0105-1873 (Linking)
VI  - 77
IP  - 1
DP  - 2017 Jul
TI  - Nadroparin carries a potentially high risk of inducing cutaneous delayed-type 
      hypersensitivity responses.
PG  - 35-41
LID - 10.1111/cod.12764 [doi]
AB  - BACKGROUND: Heparins are widely used for the prophylaxis/treatment of 
      thromboembolic events. As adverse effects, heparin-induced skin lesions occur 
      frequently (in 7.5-39% of patients). Skin lesions may be the only clinical 
      manifestation of life-threatening immune-mediated heparin-induced 
      thrombocytopenia, but are commonly caused by a delayed-type hypersensitivity 
      response [heparin-induced delayed-type hypersensitivity (HIHS)]. Risk factors 
      have not been prospectively identified. OBJECTIVES: To identify possible risk 
      factors for heparin-induced skin lesions from three independent clinical trials 
      in a combined analysis. METHODS: A pooled analysis from prospective studies was 
      performed, and possible risk factors were included in a multiple logistic 
      regression analysis. RESULTS: Obesity (body mass index of > 25), prolonged 
      anticoagulant therapy, prior heparin exposure and younger age (< 55 years) were 
      confirmed as independent risk factors for HIHS. The choice of anticoagulant 
      preparation had the greatest influence. On comparison of dalteparin, enoxaparin, 
      fondaparinux, unfractionated heparin, and nadroparin, the latter was associated 
      with the highest risk of eliciting HIHS (odds ratio of 30.2, 95%CI: 11.7-77.9). 
      CONCLUSIONS: The high risk associated with nadroparin has been validated in 
      controlled trials, and this emphasizes the singularity of each heparin 
      preparation in terms of allergenicity and that individualized anticoagulation is 
      required.
CI  - (c) 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Schindewolf, Marc
AU  - Schindewolf M
AUID- ORCID: 0000-0003-4597-0759
AD  - Division of Haemostaseology, Department of Internal Medicine, Goethe University 
      Hospital, 60590, Frankfurt am Main, Germany.
AD  - Division of Vascular Medicine, Swiss Cardiovascular Centre, University Hospital 
      Bern, 3010, Bern, Switzerland.
FAU - Recke, Andreas
AU  - Recke A
AD  - Department of Dermatology and Lubeck Institute of Experimental Dermatology, 
      University of Lubeck, 23538, Lubeck, Germany.
FAU - Zillikens, Detlef
AU  - Zillikens D
AD  - Department of Dermatology and Lubeck Institute of Experimental Dermatology, 
      University of Lubeck, 23538, Lubeck, Germany.
FAU - Lindhoff-Last, Edelgard
AU  - Lindhoff-Last E
AD  - Division of Haemostaseology, Department of Internal Medicine, Goethe University 
      Hospital, 60590, Frankfurt am Main, Germany.
AD  - Agaplesion Bethanien Hospital, Cardiovascular Centre Bethanien (CCB), 60389, 
      Frankfurt am Main, Germany.
FAU - Ludwig, Ralf J
AU  - Ludwig RJ
AD  - Department of Dermatology and Lubeck Institute of Experimental Dermatology, 
      University of Lubeck, 23538, Lubeck, Germany.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20170314
PL  - England
TA  - Contact Dermatitis
JT  - Contact dermatitis
JID - 7604950
RN  - 0 (Anticoagulants)
RN  - 0 (Nadroparin)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Anticoagulants/*adverse effects
MH  - Body Mass Index
MH  - Dermatitis, Allergic Contact/*etiology
MH  - Drug Administration Schedule
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nadroparin/*adverse effects
MH  - Pregnancy
MH  - Regression Analysis
MH  - Risk Factors
MH  - Thromboembolism/prevention & control
OTO - NOTNLM
OT  - HIHS
OT  - HIT
OT  - allergy
OT  - heparin
OT  - heparin-induced delayed-type hypersensitivity response
OT  - heparin-induced thrombocytopenia
OT  - low molecular weight heparin
OT  - skin
EDAT- 2017/03/16 06:00
MHDA- 2018/03/23 06:00
CRDT- 2017/03/16 06:00
PHST- 2016/08/15 00:00 [received]
PHST- 2016/12/09 00:00 [revised]
PHST- 2016/12/21 00:00 [accepted]
PHST- 2017/03/16 06:00 [pubmed]
PHST- 2018/03/23 06:00 [medline]
PHST- 2017/03/16 06:00 [entrez]
AID - 10.1111/cod.12764 [doi]
PST - ppublish
SO  - Contact Dermatitis. 2017 Jul;77(1):35-41. doi: 10.1111/cod.12764. Epub 2017 Mar 
      14.