Immunologic response to recombinant hirudin in HIT type II patients during long-term treatment

We prospectively investigated 27 patients with heparin-induced thrombocytopenia (HIT) type II who were subsequently treated with r-hirudin. Patients with venous or arterial thromboembolism were treated with activated partial thromboplastin time (aPTT)-controlled intravenous r-hirudin (n = 19; mean 1...

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Main Authors: Huhle, Günter (Author) , Hoffmann, Ursula (Author) , Song, Xuehong (Author) , Wang, Lianchun (Author) , Heene, Dieter L. (Author) , Harenberg, Job (Author)
Format: Article (Journal)
Language:English
Published: 1999
In: British journal of haematology
Year: 1999, Volume: 106, Issue: 1, Pages: 195-201
ISSN:1365-2141
DOI:10.1046/j.1365-2141.1999.01532.x
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1046/j.1365-2141.1999.01532.x
Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2141.1999.01532.x
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Author Notes:Huhle, Hoffmann, Song, Wang, Heene, Harenberg
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Summary:We prospectively investigated 27 patients with heparin-induced thrombocytopenia (HIT) type II who were subsequently treated with r-hirudin. Patients with venous or arterial thromboembolism were treated with activated partial thromboplastin time (aPTT)-controlled intravenous r-hirudin (n = 19; mean 19.3 d) followed by subcutaneous r-hirudin (n = 6; mean 22.5 d) and oral anticoagulation. Patients without thromboembolism were treated with subcutaneous r-hirudin (n = 8; mean 25.9 d). Four patients were readmitted to subcutaneous r-hirudin for a mean duration of 32 d. The incidence of r-hirudin antibodies was 84% for intravenously treated patients and 50% in subcutaneously treated patients. The patients (n = 27) showed a 74% overall incidence of r-hirudin antibodies, mainly of the IgG-subclass, without seroconversion before day 6 and after day 32 of r-hirudin treatment or during r-hirudin treatment. None of the patients showed onset or recurrence of venous or arterial thromboembolism, systemic allergic reactions or IgE-antibody development. During intravenous and subcutaneous administration of r-hirudin the aPTT and the ecarin clotting time was increased in the antibody-positive patients compared to antibody-negative patients. Therefore we assume that r-hirudin antibodies may reduce r-hirudin metabolism.
Item Description:Elektronische Reproduktion der Druck-Ausgabe 25 Dezember 2001
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Physical Description:Online Resource
ISSN:1365-2141
DOI:10.1046/j.1365-2141.1999.01532.x