|
|
Blood, 1 January 2005, Vol. 105, No. 1, pp. 139-144.
Prepublished online as a Blood First Edition Paper on September 23, 2004; DOI 10.1182/blood-2004-05-2010.
 Previous Article | Next Article 
Submitted June 2, 2004
Accepted August 12, 2004
Effect of fondaparinux on platelet activation in the presence of heparin-dependent antibodies. A blinded comparative multicenter study with unfractionated heparin
Pierre Savi*, Beng H Chong, Andreas Greinacher, Yves Gruel, John G Kelton, Theodore E Warkentin, Petra Eichler, Dick Meuleman, Maurice Petitou, Jean-Pascal Herault, Roger Cariou, and Jean-Marc Herbert
Sanofi~Synthelabo Recherche, Toulouse, France
Department of Medicine, St George Hospital, Kogarah, Australia
Department of Immunology and Transfusion Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany
Service d'Hematologie-Hemostase, Hopital Trousseau, Tours, France
Platelet Immunology Laboratory, McMaster University, Hamilton, Ontario, Canada
NV Organon, Oss, The Netherlands
* Corresponding author; email: pierre.savi{at}sanofi-synthelabo.com.
Heparin-induced thrombocytopenia (HIT) is a complication of heparin therapy caused by antibodies against a complex of platelet factor 4 and heparin. Fondaparinux is a new synthetic selective factor Xa inhibitor. We performed a serological study to determine the cross-reactivity of HIT sera with fondaparinux. Using a prospective, blinded study design, 39 clinically and serologically confirmed sera from patients with HIT and 15 control sera were sent to three different laboratories, each of which specialized in a particular HIT assay. These include the serotonin release assay, heparin-induced platelet agglutination assay, and platelet aggregation assay. Two of 82 assays (2.4%) performed in the presence of control sera were positive, both with unfractionated heparin. In the presence of HIT sera, 75 of 94 (79.8%) evaluable assays were positive with unfractionated heparin: fondaparinux was significantly (p<0.001) less reactive than unfractionated heparin, only three of 91 evaluable assays (3.3%) being positive. Using flow cytometry, unlike unfractionated heparin, fondaparinux did not induce the binding of PAC-1 and anti-CD62 monoclonal antibodies or of annexin V to platelets with HIT sera. Together, this study suggests that fondaparinux is non-reactive to HIT sera and raises the possibility that it may be used for prophylaxis and treatment of thrombosis in patients with a history of HIT.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
Related Article in Blood Online:
-
New insights in heparin-induced thrombocytopenia
- Michael H. Rosove
Blood 2005 105: 4-5.
[Full Text]
[PDF]
This article has been cited by other articles:
|
|
|
|
 
J. Hirsh, K. A. Bauer, M. B. Donati, M. Gould, M. M. Samama, and J. I. Weitz
Parenteral Anticoagulants: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest,
June 1, 2008;
133(6_suppl):
141S - 159S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. G.G. Turpie
Selective factor Xa inhibition with fondaparinux: from concept to clinical benefit
Eur. Heart J. Suppl.,
April 1, 2008;
10(suppl_C):
C1 - C7.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. H. Levy, K. A. Tanaka, and M. J. Hursting
Reducing Thrombotic Complications in the Perioperative Setting: An Update on Heparin-Induced Thrombocytopenia
Anesth. Analg.,
September 1, 2007;
105(3):
570 - 582.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Authors/Task Force Members, J.-P. Bassand, C. W. Hamm, D. Ardissino, E. Boersma, A. Budaj, F. Fernandez-Aviles, K. A.A. Fox, D. Hasdai, E. M. Ohman, et al.
Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology
Eur. Heart J.,
July 1, 2007;
28(13):
1598 - 1660.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Greinacher, M. Gopinadhan, J.-U. Gunther, M. A. Omer-Adam, U. Strobel, T. E. Warkentin, G. Papastavrou, W. Weitschies, and C. A. Helm
Close Approximation of Two Platelet Factor 4 Tetramers by Charge Neutralization Forms the Antigens Recognized by HIT Antibodies
Arterioscler. Thromb. Vasc. Biol.,
October 1, 2006;
26(10):
2386 - 2393.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. A Nutescu, A. K Wittkowsky, P. P Dobesh, D. W Hawkins, and W. E Dager
Choosing the Appropriate Antithrombotic Agent for the Prevention and Treatment of VTE: A Case-Based Approach
Ann. Pharmacother.,
September 1, 2006;
40(9):
1558 - 1570.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. E Efird and D. R Kockler
Fondaparinux for Thromboembolic Treatment and Prophylaxis of Heparin-Induced Thrombocytopenia
Ann. Pharmacother.,
July 1, 2006;
40(7):
1383 - 1387.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. de Maistre, Y. Gruel, and D. Lasne
Diagnosis and management of heparin-induced thrombocytopenia: [Le diagnostic et le traitement de la thrombopenie induite par l'heparine].
Can J Anesth,
June 1, 2006;
53(6_suppl):
S123 - S134.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Pendleton, M. M Wheeler, and G. M Rodgers
Argatroban Dosing of Patients with Heparin-Induced Thrombocytopenia and an Elevated aPTT Due to Antiphospholipid Antibody Syndrome
Ann. Pharmacother.,
May 1, 2006;
40(5):
972 - 976.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. M. Arepally
The immune paradox of fondaparinux
Blood,
December 1, 2005;
106(12):
3686 - 3687.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. E. Warkentin, R. J. Cook, V. J. Marder, J.-A. I. Sheppard, J. C. Moore, B. I. Eriksson, A. Greinacher, and J. G. Kelton
Anti-platelet factor 4/heparin antibodies in orthopedic surgery patients receiving antithrombotic prophylaxis with fondaparinux or enoxaparin
Blood,
December 1, 2005;
106(12):
3791 - 3796.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I.-K. Jang and M. J. Hursting
When Heparins Promote Thrombosis: Review of Heparin-Induced Thrombocytopenia
Circulation,
May 24, 2005;
111(20):
2671 - 2683.
[Full Text]
[PDF]
|
|
|
| |
