PMID- 34704283
OWN - NLM
STAT- MEDLINE
DCOM- 20220221
LR  - 20220221
IS  - 1365-2710 (Electronic)
IS  - 0269-4727 (Linking)
VI  - 47
IP  - 1
DP  - 2022 Jan
TI  - Rivaroxaban and apixaban for the treatment of suspected or confirmed 
      heparin-induced thrombocytopenia.
PG  - 112-118
LID - 10.1111/jcpt.13537 [doi]
AB  - WHAT IS KNOWN AND OBJECTIVE: Heparin-induced thrombocytopenia (HIT) is an adverse 
      hematologic drug reaction that results in thrombocytopenia. This potentially 
      life-threatening event is due to the administration of heparin products, such as 
      unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH). The 
      incidence of HIT occurs in <0.1%-7% of hospitalized patients treated with heparin 
      products, with a risk of thrombosis as high as 50%. In 2018, the American Society 
      of Hematology (ASH) recommended the utilization of direct oral anticoagulants 
      (DOACs) in clinically stable patients at average bleeding risk with HIT. The 
      objective of this study was to evaluate the prescribing patterns of rivaroxaban 
      and apixaban for the treatment of suspected or confirmed HIT. METHODS: This was a 
      retrospective chart review from January 2013 through October 2019 at the 
      University of Chicago Medicine. Twelve patients were identified to have received 
      a DOAC for suspected or confirmed HIT. RESULTS: Rivaroxaban was utilized in seven 
      (58%) patients, six of whom received argatroban prior to starting rivaroxaban. 
      Five (71%) of these patients were started on the recommended dose of rivaroxaban 
      for VTE. Apixaban was utilized in five (42%) patients; four patients were started 
      on argatroban and transitioned to apixaban. One patient was started on the 
      suggested dose of apixaban for VTE. WHAT IS NEW AND CONCLUSION: After starting 
      DOACs for suspected HIT, no patients had new thrombosis during hospitalization. 
      Eight patients (67%) followed up at our institution within 6 months of their 
      discharge date. No subsequent thrombi formation were identified for any of these 
      patients. The results of this study add to the expanding literature regarding the 
      safety and efficacy of DOAC use in HIT, and indicate DOACs are being increasingly 
      utilized for the treatment of confirmed or suspected HIT.
CI  - (c) 2021 John Wiley & Sons Ltd.
FAU - Cirbus, Kristen
AU  - Cirbus K
AUID- ORCID: 0000-0001-7848-5720
AD  - Department of Pharmacy Services, University of Chicago Medicine, Chicago, 
      Illinois, USA.
FAU - Simone, Pamela
AU  - Simone P
AUID- ORCID: 0000-0003-1070-0740
AD  - Department of Pharmacy Services, University of Chicago Medicine, Chicago, 
      Illinois, USA.
FAU - Austin Szwak, Jennifer
AU  - Austin Szwak J
AUID- ORCID: 0000-0002-9911-5750
AD  - Department of Pharmacy Services, University of Chicago Medicine, Chicago, 
      Illinois, USA.
LA  - eng
PT  - Journal Article
DEP - 20211026
PL  - England
TA  - J Clin Pharm Ther
JT  - Journal of clinical pharmacy and therapeutics
JID - 8704308
RN  - 0 (Factor Xa Inhibitors)
RN  - 0 (Pipecolic Acids)
RN  - 0 (Pyrazoles)
RN  - 0 (Pyridones)
RN  - 0 (Sulfonamides)
RN  - 3Z9Y7UWC1J (apixaban)
RN  - 9005-49-6 (Heparin)
RN  - 94ZLA3W45F (Arginine)
RN  - 9NDF7JZ4M3 (Rivaroxaban)
RN  - IY90U61Z3S (argatroban)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Arginine/analogs & derivatives/therapeutic use
MH  - Factor Xa Inhibitors/*therapeutic use
MH  - Female
MH  - Heparin/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pipecolic Acids/therapeutic use
MH  - Pyrazoles/*therapeutic use
MH  - Pyridones/*therapeutic use
MH  - Retrospective Studies
MH  - Rivaroxaban/*therapeutic use
MH  - Sulfonamides/therapeutic use
MH  - Thrombocytopenia/*chemically induced/*drug therapy
OTO - NOTNLM
OT  - anticoagulation
OT  - clinical pharmacy
EDAT- 2021/10/28 06:00
MHDA- 2022/02/22 06:00
CRDT- 2021/10/27 07:22
PHST- 2021/09/09 00:00 [revised]
PHST- 2021/06/18 00:00 [received]
PHST- 2021/09/22 00:00 [accepted]
PHST- 2021/10/28 06:00 [pubmed]
PHST- 2022/02/22 06:00 [medline]
PHST- 2021/10/27 07:22 [entrez]
AID - 10.1111/jcpt.13537 [doi]
PST - ppublish
SO  - J Clin Pharm Ther. 2022 Jan;47(1):112-118. doi: 10.1111/jcpt.13537. Epub 2021 Oct 
      26.