What are acceptable anticoagulants to use in heparin-induced thrombocytopenia (HIT)?

By William Aird

  • Argatroban
  • Bivalirudin
  • Danaparoid
  • Fondaparinux – especially in clinically stable patients at average risk of bleeding, and provided normal renal function.
  • DOAC:
    • Especially in clinically stable patients at average risk of bleeding.
    • Most of the published experience in HIT is with rivaroxaban.
Effectiveness and safety outcomes of various anticoagulants used in the treatment of HIT. Pooled proportions of (A) platelet recovery, (B) thromboembolism, (C) major bleeding, and (D) death are shown according to the treatment scheme. The logit-transformed proportions were pooled using a random-effects model based on a random intercept logistic regression model. Groups, number of treatment groups; 95% CI, 95% confidence interval; n, number of patients. Confidence intervals were mostly overlapping, and results were not influenced by patient population, diagnostic test used, study design, or type of article. Source.