Fondaparinux‐associated heparin‐induced thrombocytopenia

Abstract

The risk of fondaparinux-associated HIT, although low is real, which along with documented cases of fondaparinux failure mandate its cautious use in the management of HIT.

Pharmacology of Heparin and Related Drugs

“…Moreover, reports suggest that fondaparinux is frequently used in patients who cannot receive UH or LMWH because of HIT (Schindewolf et al, 2014), and there are reports both of fondaparinux being used successfully in patients with existing HIT (Lobo et al, 2008;Kang et al, 2015) and of a lack of cross-reaction with HIT antibodies (Savi et al, 2005;Weitz and Weitz, 2010). However, there are also reports that fondaparinux can, in rare cases, cause problems in this setting (Warkentin, 2010;Warkentin et al, 2007Warkentin et al, , 2014Bhatt et al, 2013). Looking forward, it seems likely that use of the orally active direct FIIa and FXa inhibitors (NOACs) will become the established treatment approach in patients with HIT, because reports of their successful use in this context exist (Hantson et al, 2015;Sharifi et al, 2015).…”

Severe and persistent heparin‐induced thrombocytopenia despite fondaparinux treatment

“…However, there have been several case reports describing fondaparinux-induced thrombocytopenia. Vijaya R. Bhatt et al summarized eight cases of fondaparinux-associated HIT reported until May 2013 [13]. Most patients were after major orthopedic surgery.…”

Heparin-induced thrombocytopenia: research and clinical updates

“…43 In a minority of patients, fondaparinux has been reported to cause HIT. 44 Given the number of limited reports, the incidence of fondaparinux-induced HIT remains unknown. Several retrospective series, however, have demonstrated the safety and efficacy of fondaparinux in the treatment of HIT.…”