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

• Verfasst von: Huhle, Günter [VerfasserIn]
• Verfasst von: Hoffmann, Ursula [VerfasserIn]
• Verfasst von: Song, Xuehong [VerfasserIn]
• Verfasst von: Wang, Lianchun [VerfasserIn]
• Verfasst von: Heene, Dieter L. [VerfasserIn]
• Verfasst von: Harenberg, Job [VerfasserIn]
• Titel: Immunologic response to recombinant hirudin in HIT type II patients during long-term treatment
• Verf.angabe: Huhle, Hoffmann, Song, Wang, Heene, Harenberg
• Jahr: 1999
• Umfang: 7 S.
• Fussnoten: Elektronische Reproduktion der Druck-Ausgabe 25 Dezember 2001 ; Gesehen am 05.05.2022
• Titel Quelle: Enthalten in: British journal of haematology
• Ort Quelle: Oxford [u.a.] : Wiley-Blackwell, 1955
• Jahr Quelle: 1999
• Band/Heft Quelle: 106(1999), 1, Seite 195-201
• ISSN Quelle: 1365-2141
• DOI: doi:10.1046/j.1365-2141.1999.01532.x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: allergy
• Sach-SW: antibodies
• Sach-SW: heparin-induced thrombocytopenia
• Sach-SW: recombinant hirudin
• K10plus-PPN: 1801054975

Abstract

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.