Fondaparinux for Thromboembolic Treatment and Prophylaxis of Heparin-Induced Thrombocytopenia

Abstract

Limited data support the use of fondaparinux for thromboembolic treatment or prophylaxis in patients with antibody assay-confirmed HIT who do not have a contraindication for fondaparinux use. Randomized controlled trials have not been published; therefore, questions remain regarding efficacy, safety, optimal doses, treatment duration, and incidence of thromboembolic events when fondaparinux is used in this setting. Prospective trials evaluating the efficacy and safety of fondaparinux in this patient population need to be conducted to answer these questions.

Anticoagulation in a Neurosurgical Patient with Heparin-Induced Thrombocytopenia Type II with Argatroban and Fondaparinux after Clipping of an Intracranial Aneurysm

“…The implantation of a rIVC could only take place some days after the embolic event as the filter was not readily available. Until our patient was treated, fondaparinux had not been shown to have a cross-sensitivity in HIT II syndrome, so we did not see any obstacle to use it in our patient [7]. However, a case report from 2007 associates HIT II with the use of fondaparinux [8].…”

Heparin-induced Thrombocytopenia As A Cause of Deep Venous Thrombosis: Effectiveness of Fondaparinux in Dialysis Patients

“…However, the onset of thrombocytopenia usually occurs 4 to 14 days after the administration of the heparin in patients receiving heparin for the first time. In delayed-onset HIT, the thrombocytopenia occurs 5 or more days after heparin withdrawal (1,5).…”

Warfarin-Induced Skin Necrosis in a Patient with Heparin-Induced Thrombocytopenia: Two Diseases or One?

“…After 6 days the anticoagulant was switched to the subcutaneously administered factor X inhibitor fondaparinux. Although there is no randomized prospective data proving fondaparinux’s efficacy and safety in managing HIT, many observational studies suggest that fondaparinux is a safe and convenient treatment in patients with HIT [20,21,22]. Furthermore, fondaparinux has been shown to be as effective as unfractionated heparin in the treatment of patients with pulmonary embolism [23] (which was the patient’s presenting diagnosis).…”