uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Results of a systematic evaluation of treatment outcomes for heparin-induced thrombocytopenia in patients receiving danaparoid, ancrod, and/or coumarin explain the rapid shift in clinical practice during the 1990s.
Department of Transfusion Medicine, Greifswald University, Germany.
Show others and affiliations
2006 (English)In: Thrombosis Research, ISSN 0049-3848, E-ISSN 1879-2472, Vol. 117, no 5, 507-15 p.Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Randomized controlled trials evaluating treatment of acute, transient, but uncommon diseases are difficult to perform. The prothrombotic adverse drug reaction, heparin-induced thrombocytopenia (HIT), is such an example. During the mid-1980s, the defibrinogenating snake venom, ancrod (+/-warfarin, Canada), or coumarin (warfarin, Canada; phenprocoumon, Germany) alone, were often used to treat HIT. During the 1990s, danaparoid+/-coumarin began to replace ancrod (+/-coumarin), or coumarin alone, for treating HIT, despite danaparoid not being approved for treatment of HIT.

METHODS: We performed a retrospective evaluation of treatment outcomes from 1986 to 1999, comparing danaparoid+/-coumarin (n=62) versus ancrod+/-coumarin or coumarin alone (controls, n=56).

RESULTS: The predefined composite endpoint of adjudicated new, progressive, or recurrent thrombosis (including thrombotic death), or limb amputation, at day 7 (maximum, one event per patient) was significantly lower in danaparoid-treated patients, compared with controls: 8/62=12.9% (95% CI, 4.3-21.5) vs. 22/56=39.3% (95% CI, 26.1-52.5); p=0.0014. We also found a lower frequency of the composite endpoint at end of study (day 35) in danaparoid-treated patients: 12/62=19.4% vs. 24/56=42.9% (p=0.0088). Major bleeding (by day 7) occurred in 7/62 (11.3%) and 16/56 (28.6%) of danaparoid-treated and control patients, respectively (p=0.0211).

CONCLUSIONS: The replacement of ancrod+/-coumarin, or coumarin alone, by danaparoid (+/-coumarin) in the mid-1990s for the treatment of HIT was justified by improved efficacy and safety.

Place, publisher, year, edition, pages
2006. Vol. 117, no 5, 507-15 p.
National Category
Clinical Medicine
URN: urn:nbn:se:uu:diva-161361DOI: 10.1016/j.thromres.2005.04.011PubMedID: 15907979OAI: oai:DiVA.org:uu-161361DiVA: diva2:456028
Available from: 2011-11-11 Created: 2011-11-11 Last updated: 2011-11-30

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Lubenow, Norbert
In the same journal
Thrombosis Research
Clinical Medicine

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 122 hits
ReferencesLink to record
Permanent link

Direct link