Desirudin: A review of the pharmacology and clinical application for the prevention of deep vein thrombosis

Expert Review of Cardiovascular Therapy

Volumn 9, Issue 9, 2011, Pages 1101-1109

  Graetz, Thomas J ^a   Tellor, Bethany R ^b   Smith, Jennifer R ^b   Avidan, Michael S ^a  

^a WASHINGTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b BARNES JEWISH HOSPITAL   (United States)

Author keywords

deep vein thrombosis; desirudin; desulfato hirudin; direct thrombin inhibitor; heparin induced thrombocytopenia; Iprivask ; thrombosis prophylaxis; venous thromboembolism

Indexed keywords

ARGATROBAN; DABIGATRAN; DANAPAROID; DESULFATOHIRUDIN; ENOXAPARIN; HEPARIN; HEPARIN PLATELET FACTOR 4 ANTIBODY; HIRULOG; LEPIRUDIN; LOW MOLECULAR WEIGHT HEPARIN; THROMBIN INHIBITOR; WARFARIN; XIMELAGATRAN;

ALLERGIC REACTION; ANAPHYLAXIS; ANEMIA; ANTICOAGULANT THERAPY; BLEEDING; CEREBROVASCULAR DISEASE; DEEP VEIN THROMBOSIS; DIZZINESS; DRUG ABSORPTION; DRUG CONTRAINDICATION; DRUG DISTRIBUTION; DRUG DOSE REGIMEN; DRUG EFFICACY; DRUG ELIMINATION; DRUG INDICATION; DRUG SAFETY; DRUG STRUCTURE; EPISTAXIS; FEVER; HEARING IMPAIRMENT; HEMATEMESIS; HEMATOMA; HEMATURIA; HEMOGLOBIN BLOOD LEVEL; HEPARIN INDUCED THROMBOCYTOPENIA; HIGH RISK PATIENT; HIP ARTHROPLASTY; HUMAN; HYPOTENSION; IMMUNOGENICITY; INFECTION; INJECTION SITE MASS; KIDNEY DYSFUNCTION; LEG EDEMA; LEG PAIN; NAUSEA; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SIDE EFFECT; SINGLE DRUG DOSE; THROMBOSIS; THROMBOSIS PREVENTION; VOMITING; WOUND DEHISCENCE; WOUND FLUID;

ANIMALS; ANTICOAGULANTS; ANTITHROMBINS; DOSE-RESPONSE RELATIONSHIP, DRUG; HEMORRHAGE; HIRUDINS; HUMANS; RECOMBINANT PROTEINS; RENAL INSUFFICIENCY; VENOUS THROMBOSIS;

EID: 80053095416     PISSN: 14779072     EISSN: 17448344     Source Type: Journal    
DOI: 10.1586/erc.11.131     Document Type: Review

References (41)

1. Eriksson BI. New therapeutic options in deep vein thrombosis prophylaxis. Semin. Hematol. 37(3 Suppl. 5), 7-9 (2000).
2. Geerts WH, Bergqvist D, Pineo GF et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133(Suppl. 6), 381S-453S (2008). (Pubitemid 351894916)
3. Reis SE, Polak JF, Hirsch DR et al. Frequency of deep venous thrombosis in asymptomatic patients with coronary artery bypass grafts. Am. Heart J. 122(2), 478-482 (1991).
4. Franchini M. Heparin-induced thrombocytopenia: an update. Thromb. J. 3, 14 (2005).
5. Warkentin TE, Sheppard JA, Horsewood P, Simpson PJ, Moore JC, Kelton JG. Impact of the patient population on the risk for heparin-induced thrombocytopenia. Blood 96(5), 1703-1708 (2000). (Pubitemid 30661052)
6. Warkentin TE, Greinacher A, Koster A, Lincoff AM. Treatment and prevention of heparin-induced thrombocytopenia: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133(Suppl. 6), 340S-380S (2008). (Pubitemid 351892970)
7. Bauer TL, Arepally G, Konkle BA et al. Prevalence of heparin-associated antibodies without thrombosis in patients undergoing cardiopulmonary bypass surgery. Circulation 95(5), 1242-1246 (1997). (Pubitemid 27097836)
8. Pouplard C, May MA, Iochmann S et al. Antibodies to platelet factor 4 - heparin after cardiopulmonary bypass in patients anticoagulated with unfractionated heparin or a low-molecular-weight heparin: clinical implications for heparin-induced thrombocytopenia. Circulation 99(19), 2530-2536 (1999). (Pubitemid 29228283)
9. Bauer KA. New anticoagulants. Curr. Opin. Hematol. 15(5), 509-515 (2008).
10. Selleng S, Malowsky B, Itterman T et al. Incidence and clinical relevance of anti-platelet factor 4/heparin antibodies before cardiac surgery. Am. Heart J. 160(2), 362-369 (2010).
11. Singer RL, Mannion JD, Bauer TL, Armenti FR, Edie RN. Complications from heparin-induced thrombocytopenia in patients undergoing cardiopulmonary bypass. Chest 104(5), 1436-1440 (1993). (Pubitemid 23327859)
12. Lubenow N, Kempf R, Eichner A, Eichler P, Carlsson LE, Greinacher A. Heparin-induced thrombocytopenia: temporal pattern of thrombocytopenia in relation to initial use or reexposure to heparin. Chest 122(1), 37-42 (2002). (Pubitemid 34754140)
13. Warkentin TE, Kelton JG. Temporal aspects of heparin-induced thrombocytopenia. N. Engl. J. Med. 344(17), 1286-1292 (2001). (Pubitemid 32372963)
14. Lo GK, Sigouin CS, Warkentin TE. What is the potential for overdiagnosis of heparin-induced thrombocytopenia? Am. J. Hematol. 82(12), 1037-1043 (2007). (Pubitemid 350209843)
15. Crowther MA, Cook DJ, Albert M et al. The 4Ts scoring system for heparin-induced thrombocytopenia in medical-surgical intensive care unit patients. J. Crit. Care 25(2), 287-293 (2010).
16. Prechel M, Walenga JM. The laboratory diagnosis and clinical management of patients with heparin-induced thrombocytopenia: an update. Semin. Thromb. Hemost. 34(1), 86-96 (2008). (Pubitemid 351640884)
17. Selleng S, Malowsky B, Strobel U. Early-onset and persisting thrombocytopenia in post-cardiac surgery patients is rarely due to heparin-induced thrombocytopenia, even when antibody tests are positive. J. Thromb. Haemost. 8(1), 30-36 (2010).
18. Ruf KM, Bensadoun ES, Davis GA, Flynn JD, Lewis DA. A clinical-laboratory algorithm incorporating optical density value to predict heparin-induced thrombocytopenia. Thromb. Haemost. 105(3), 553-559 (2011).
19. Talbot M. Biology of recombinant hirudin (CGP 39393): a new prospect in the treatment of thrombosis. Semin. Thromb. Hemost. 15(3), 293-301 (1989).
20. Nowak G. Pharmacology of recombinant hirudin. Semin. Thromb. Hemost. 28(5), 415-424 (2002).
21. Desirudin (Iprivask), package instert. Hunt Valley, MD. Canyon PharmaceuticalsTM, NY, USA.
22. Stringer KA, Lindenfeld J. Hirudins: antithrombin anticoagulants. Ann. Pharmacother. 26(12), 1535-1540 (1992).
23. Fenton JW 2nd, Villanueva GB, Ofosu FA, Maraganore JM. Thrombin inhibition by hirudin: how hirudin inhibits thrombin. Haemostasis 21(Suppl. 1), 27-31 (1991).
24. Markwardt F. Past, present and future of hirudin. Haemostasis 21(Suppl. 1), 11-26 (1991).
25. Markwardt F. Hirudin as alternative anticoagulant - a historical review. Semin. Thromb. Hemost. 28(5), 405-414 (2002).
26. Verstraete M, Nurmohamed M, Kienast J et al. Biologic effects of recombinant hirudin (CGP 39393) in human volunteers. European Hirudin in Thrombosis Group. J. Am. Coll. Cardiol. 22(4), 1080-1088 (1993). (Pubitemid 23285758)
27. Lefevre G, Duval M, Gauron S et al. Effect of renal impairment on the pharmacokinetics and pharmacodynamics of desirudin. Clin. Pharmacol. Ther. 62(1), 50-59 (1997). (Pubitemid 27327099)
28. Nafziger AN, Bertino JS Jr. Desirudin dosing and monitoring in moderate renal impairment. J. Clin. Pharm. 50(6), 614-622 (2010).
29. Eriksson BI, Ekman S, Kalebo P, Zachrisson B, Bach D, Close P. Prevention of deep-vein thrombosis after total hip replacement: direct thrombin inhibition with recombinant hirudin, CGP 39393. Lancet 347(9002), 635-639 (1996). (Pubitemid 26076128)
30. Eriksson BI, Wille-Jorgensen P, Kalebo P et al. A comparison of recombinant hirudin with a low-molecular-weight heparin to prevent thromboembolic complications after total hip replacement. N. Engl. J. Med. 337(19), 1329-1335 (1997). (Pubitemid 27467766)
31. Avidan MS, Smith JR, Skrupky LP et al. The occurrence of antibodies to heparin-platelet factor 4 in cardiac and thoracic surgical patients receiving desirudin or heparin for postoperative venous thrombosis prophylaxis. Thromb. Res. DOI: 10.1016/j.thromres.2011.05.025 (2011) (Epub ahead of print).
32. Marbet GA, Verstraete M, Kienast J et al. Clinical pharmacology of intravenously administered recombinant desulfatohirudin (CGP 39393) in healthy volunteers. J. Cardiovasc. Pharmacol. 22(3), 364-372 (1993). (Pubitemid 23241109)
33. Eriksson BI, Kalebo P, Ekman S, Lindbratt S, Kerry R, Close P. Direct thrombin inhibition with Rec-hirudin CGP 39393 as prophylaxis of thromboembolic complications after total hip replacement. Thromb. Haemost. 72(2), 227-231 (1994). (Pubitemid 24251285)
34. Eriksson BI, Ekman S, Lindbratt S et al. Prevention of thromboembolism with use of recombinant hirudin. Results of a double-blind, multicenter trial comparing the efficacy of desirudin (Revasc) with that of unfractionated heparin in patients having a total hip replacement. J. Bone Joint Surg. 79(3), 326-333 (1997). (Pubitemid 27136640)
35. Eichler P, Friesen HJ, Lubenow N, Jaeger B, Greinacher A. Antihirudin antibodies in patients with heparin-induced thrombocytopenia treated with lepirudin: incidence, effects on aPTT, and clinical relevance. Blood 96(7), 2373-2378 (2000).
36. Song X, Huhle G, Wang L, Hoffmann U, Harenberg J. Generation of anti-hirudin antibodies in heparin-induced thrombocytopenic patients treated with r-hirudin. Circulation 100(14), 1528-1532 (1999). (Pubitemid 29461465)
37. Huhle G, Hoffmann U, Song X, Wang LC, Heene DL, Harenberg J. Immunologic response to recombinant hirudin in HIT type II patients during long-term treatment. Br. J. Haematol. 106(1), 195-201 (1999). (Pubitemid 29343551)
38. Greinacher A, Eichler P, Albrecht D, Strobel U, Potzsch B, Eriksson BI. Antihirudin antibodies following low-dose subcutaneous treatment with desirudin for thrombosis prophylaxis after hip-replacement surgery: incidence and clinical relevance. Blood 101(7), 2617-2619 (2003). (Pubitemid 36857621)
39. Close P, Bichler J, Kerry R et al. Weak allergenicity of recombinant hirudin CGP 39393 (REVASC) in immunocompetent volunteers. The European Hirudin in Thrombosis Group (HIT Group). Coron. Artery Dis. 5(11), 943-949 (1994).
40. Hirsh J, Bauer KA, Donati MB, Gould M, Samama MM, Weitz JI. Parenteral anticoagulants: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133(Suppl. 6), 141S-159S (2008). (Pubitemid 351892966)
41. Boyce SW, Bandyk DF, Bartholomew JR, Frame JN, Rice L. A Randomized, Open-Label Pilot Study Comparing Desirudin and Argatroban in Patients With Suspected Heparin-Induced Thrombocytopenia With or Without Thrombosis: PREVENT-HIT study. Am. J. Ther. PMID: 21079512 (2010) (Epub ahead of print).