Pharmacology of argatroban

Jeske, Walter; Fareed, Jawed; Hoppensteadt, Debra; Lewis, Bruce E.; Walenga, Jeanine M.

doi:10.1586/ehm.10.53

Cited by 36 publications

(19 citation statements)

References 93 publications

(79 reference statements)

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“…Argatroban, another DTI given by continuous intravenous infusion, is most often used in children suspected or diagnosed with or at risk for HIT . Argatroban is hepatically cleared via CYP3A4/5, bivalirudin is partially cleared via the kidneys, and the remainder undergoes intracellular proteolysis …”

Section: Treatmentmentioning

confidence: 99%

Deep vein thrombosis in pediatric patients

Jaffray

2017

Pediatric Blood & Cancer

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Due to advances in caring for critically ill children and those with chronic diseases, rates of deep vein thrombosis (DVT) are increasing in children. Risk factors consist of central venous catheters, chronic medical conditions, thrombophilia, and various medications. Compression Doppler ultrasonography is the method most commonly used to diagnose DVT, and patients will usually present with pain and swelling of the affected limb. Anticoagulation via subcutaneous injection is the most common treatment regime for children with DVT, and the new, direct oral anticoagulants are currently under investigation. Prevention techniques are not established, but clinical studies are addressing this need.

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Section: Treatmentmentioning

confidence: 99%

Deep vein thrombosis in pediatric patients

Jaffray

2017

Pediatric Blood & Cancer

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“…Another possible explanation for our ﬁndings might be the powerful anticoagulant and anti-inﬂammatory effects of argatroban. Argatroban can also inhibit soluble and postclotting thrombin which binds to fibrin or blood clot, and is better than heparin and other direct thrombin inhibitors [27]. Furthermore, other advantages include antiplatelet effect by reducing the thrombin-mediated activation of platelets [28], the protective effect of endothelial cells [29], and downregulation of various inflammatory and thrombotic cytokines [30].…”

Section: Discussionmentioning

confidence: 99%

Argatroban for Preventing Occlusion and Restenosis after Extracranial Artery Stenting

Zhou

Liu

et al. 2014

Eur Neurol

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Background/Aims: Restenosis following extracranial artery stenting is a limitation that affects long-term outcomes. Effective and satisfying pharmacological strategies in preventing restenosis have not been established. This study aimed to evaluate whether argatroban, a direct thrombin inhibitor, could reduce the risk of in-stent restenosis after extracranial artery stenting. Methods: One hundred and fourteen patients hospitalized between August 2010 and August 2011 were enrolled. Patients were randomly assigned to argatroban (n = 58) and blank control groups (n = 56). The patients in the argatroban arm were treated with 10 mg of intravenous argatroban twice daily 2 days before and 3 days after the stenting procedures. Patients were followed for 12 months after the procedure. During follow-up, restenosis and target revascularization were analyzed. Recurrent cerebrovascular and cardiovascular events and deaths were also compared between the groups. Results: One patient in the stenting group withdrew immediately after the procedure due to unsuccessful stenting. Restenosis occurred in 4 patients (7.4%) in the argatroban group and in 11 patients (21.6%) in the control group during the 6- to 9-month angiographic follow-up period (p = 0.032). Nine months after the procedures, argatroban-treated patients had a trend towards a lower incidence of target revascularization compared with the controls (5.4 vs. 13.7%, p = 0.188). No major bleeding events or other adverse events occurred in the argatroban group. Conclusion: This pilot clinical trial is the first that uses argatroban to prevent restenosis in ischemic cerebrovascular disease, and suggests that intravenous administration of argatroban is effective and safe in preventing restenosis after extracranial artery stenting. Larger randomized controlled clinical trials are warranted.

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“…Argatroban is a univalent DTI that binds solely to the active site of thrombin. It is metabolized by hepatic CYP3A4/5 oxidases and is excreted primarily in the feces [36,41,42]. Menk and colleagues retrospectively reviewed 78 adult patients with acute respiratory distress syndrome (ARDS) on ECMO.…”

Section: Argatrobanmentioning

confidence: 99%

Anticoagulation in Pediatric Extracorporeal Membrane Oxygenation

Weller¹,

Raman²,

Zia³

et al. 2019

Advances in Extracorporeal Membrane Oxygenation - Volume 3

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Anticoagulation during extracorporeal membrane oxygenation (ECMO) is necessary to prevent catastrophic circuit clotting, but significant morbidity and mortality continue to be attributed to hemorrhagic and thrombotic complications. Due to the inflammatory response from the extracorporeal circuit and developmental hemostasis, anticoagulation can be challenging particularly for pediatric patients. Unfractionated heparin (UFH) is the gold standard anticoagulant used in ECMO, but there is an expanding area of research evaluating other anticoagulants, such as direct thrombin inhibitors. This chapter provides an overview of anticoagulant options for pediatric patients on ECMO as well as describes the various tests used to monitor and titrate anticoagulation.

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Pharmacology of argatroban

Cited by 36 publications

References 93 publications

Deep vein thrombosis in pediatric patients

Deep vein thrombosis in pediatric patients

Argatroban for Preventing Occlusion and Restenosis after Extracranial Artery Stenting

Anticoagulation in Pediatric Extracorporeal Membrane Oxygenation

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