"Danaparoid"

Heparin Anti-Xa Activity, a Readily Available Unique Test to Quantify Apixaban, Rivaroxaban, Fondaparinux, and Danaparoid Levels. Despite their usefulness in perioperative and acute care settings, factor-Xa inhibitor-specific assays are scarcely available, contrary to heparin anti-Xa assay. We assessed whether the heparin anti-Xa assay can (1) be used as a screening test to rule out apixaban , rivaroxaban, fondaparinux, and danaparoid levels that contraindicate invasive procedures according to current guidelines (>30 ng·mL-1, >30 ng·mL-1, >0.1 µg·mL-1, and >0.1 IU·mL-1, respectively), (2) quantify the anticoagulant level if found significant, that is, if it exceeded the abovementioned threshold. In the derivation cohort then in the validation cohort, via receiver operating characteristics (ROC

Danaparoid sodium-based anticoagulation therapy for portal vein thrombosis in cirrhosis patients. Portal vein thrombosis (PVT) is a common complication of cirrhosis. However, in patients with PVT and cirrhosis, there is no clear evidence supporting effective treatment modalities. In this study, we examined the effectiveness and safety of anticoagulation therapy using danaparoid sodium for PVT in patients with cirrhosis. This retrospective study assessed 52 cirrhotic patients with PVT treated with danaparoid sodium for 2 weeks between November 2008 and September 2018. The primary outcome measure was the post-treatment status of PVT assessed by reduction in thrombus volume and safety of the therapeutic intervention. PVT status was evaluated with contrast-enhanced computed tomography (CECT). All

Cross-Reactivity Between Heparin and Danaparoid Antibodies in Cardiac Surgery. Management of heparin-induced thrombocytopenia (HIT) entails cessation of heparin and initiation of a nonheparin parenteral anticoagulant such as danaparoid. Danaparoid cross-reactivity with HIT antibodies is an uncommon complication of treatment of HIT. We report the case of confirmed HIT and in vivo cross-reactivity with danaparoid, complicating severe sepsis due to an infectious endocarditis treated by cardiac surgery.

Usefulness of Danaparoid sodium in patients with Heparin-induced thrombocytopenia after cardiac surgery Thrombocytopenia is a common problem in cardiovascular surgery patients. However, heparin-induced thrombocytopenia (HIT) is a rare but life-threatening complication of prophylaxis or treatment with heparin. Prompt management of HIT with an alternative anticoagulant is necessary due to the extreme risk of thrombotic complications. Therefore, we evaluated the effects of danaparoid in the treatment of HIT in patients with cardiac surgery who are at moderate to high risk of HIT. A prospective observational study involving 418 postcardiac surgery patients who received unfractionated heparin and low-molecular weight heparin was conducted in an educational tertiary cardiac care hospital in Iran

Optimizing Risk Stratification in Portal Vein Thrombosis after Splenectomy and its Primary Prophylaxis with Antithrombin III Concentrates and Danaparoid Sodium in Liver Cirrhosis with Portal Hypertension. Decreased antithrombin III (ATIII) activity and large splenic vein diameter (SVD) are risk factors for portal vein thrombosis (PVT) after splenectomy in liver cirrhosis with portal hypertension concentrates (1,500 U/day) for 3 days; and those at highest risk (SVD ≥15 mm) received ATIII concentrates for 3 days, followed by danaparoid sodium (2,500 U/day) for 14 days and warfarin. In the validation cohort, 0 of 14 low-risk and 2 of 32 high-risk patients had PVT. Although 8 of 11 patients at highest risk had temporary PVT, it disappeared within 3 months postoperatively. Finally, only 2 (3.5%) of 57

Effects of argatroban, danaparoid, and fondaparinux on trombin generation in heparin-induced thrombocytopenia. There is no in vitro data on the comparison of the effects of danaparoid, argatroban and fondaparinux on thrombin generation in patients with heparin-induced thrombocytopenia. It was the study objective to compare the in vitro anticoagulant potential of argatroban, danaparoid and fondaparinux using a thrombin generation assay TGA on a mixture of control platelet-rich plasma (PRP) and HIT patient platelet-poor plasma (PPP). The plasma of seven patients with a clear HIT diagnosed at our institution was selected. Mixtures of donor PRP and patient PPP were incubated with unfractionated heparin 0.2 U.mL⁻¹, argatroban at 600 ng.mL⁻¹, argatroban at 400 ng.mL⁻¹, danaparoid at 0.65 IU.mL

Multicentric Prospective Validation of a Universal Test to Quantify Apixaban, Rivaroxaban, Danaparoid and Fondaparinux Levels Despite their usefulness in perioperative and acute care settings, factor-Xa inhibitors-specific assays are scarcely available, contrary to heparin anti-Xa assay. The investigators aimed at assessing whether the widely used heparin anti-Xa assay can quantify the apixaban , rivaroxaban, fondaparinux and danaparoid levels. undefined

, prophylactic heparin, heparin locks or flushes, andremove heparin-coated catheters.Start anticoagulation with a non-heparin, HIT-safe anticoagulant such as fondaparinux, argatroban, adirect oral anticoagulant (DOAC), bivalirudin, or danaparoid (see Table 2 for dosing). If a newthrombotic event is present (HIT with thrombosis, or “HITT”), then the acute VTE treatment regimen forthe DOAC is preferred, rather . Danaparoid does notcross the placenta and has been used to treat HIT in pregnancy. The use of fondaparinux (with the cautionsnoted above) is an option where danaparoid is not available; however, this drug has been reported to crossthe placenta in small amounts and experience with fondaparinux in pregnancy is very limited (especiallyduring the first trimester). Argatroban use has been described in pregnant

anticoagulation. Consensus recommendation Use non-heparin drugs for anticoagulation treatment for VITT, for example: • direct oral anticoagulants • fondaparinux • danaparoid sodium • argatroban. When using argatroban as an anticoagulation treatment for people with VITT, switch to fondaparinux or a direct oral anticoagulant as soon as the bleeding risk has reduced. Remark: Avoid using heparins, including recommendation For people with VITT without confirmed thrombosis, but who have thrombocytopenia with very high D-dimer and a positive ELISA for platelet factor 4 antibodies, consider venous thromboembolism (VTE) thromboprophylaxis after taking into account the benefits and risks of treatment. Use non-heparin drugs such as direct oral anticoagulants, fondaparinux, or danaparoid sodium, and regularly reassess

nutrition), and an alternative “HIT-safe” anticoagulant such as argatroban, danaparoid, bivalirudin, fondaparinux, or a direct oral anticoagulant should generally be started. There is some evidence to support the safety of direct oral anticoagulants for treatment of HIT, but their use for this purpose is still considered off-label, as is that of bivalirudin and fondaparinux (see Clinical Guide: Heparin

, adirect oral anticoagulant (DOAC), bivalirudin, or danaparoid (see Table 2 for dosing). If a newthrombotic event is present (HIT with thrombosis, or “HITT”), then the acute VTE treatment regimen forthe DOAC is preferred, rather than the maintenance dosing regimen. For example, rivaroxaban shouldbe initiated at 15 mg BID x 3 weeks followed by 20 mg daily.Consider if the patient may already have had and an adult hematologist,supported by consultation with an experienced pediatric hematologist, is recommended.Pregnancy:HIT is infrequent in pregnancy. The approach to investigation is as outlined above. Danaparoid does notcross the placenta and has been used to treat HIT in pregnancy. The use of fondaparinux (with the cautionsnoted above) is an option where danaparoid is not available; however, this drug

is suspected or diagnosed, all sources of heparinmust be stopped (e.g. flushes, prothrombin complex concentrate, some total parenteral nutrition), andan alternative “HIT-safe” anticoagulant such as argatroban, danaparoid, bivalirudin, fondaparinux, or adirect oral anticoagulant should generally be started. There is some evidence to support the safety ofdirect oral anticoagulants for treatment of HIT

or flushes, and remove heparin-coated catheters. • Start anticoagulation with a non-heparin, HIT-safe anticoagulant such as fondaparinux, argatroban, a direct oral anticoagulant (DOAC), bivalirudin, or danaparoid (see Table 2 for dosing). If a new thrombotic event is present (HIT with thrombosis, or “HITT”), then the acute VTE treatment regimen for the DOAC is preferred, rather than the maintenance dosing has resolved. If transitioning to warfarin from a HIT-safe anticoagulant, such as fondaparinux, bivalirudin, or danaparoid: – Do not initiate warfarin until platelet count is ≥150 x 109/L. – Overlap warfarin with therapeutic doses of the HIT-safe anticoagulant for ≥5 days and until the international normalized ratio (INR) is therapeutic. Caution should be used when transitioning to warfarin from

nutrition), and an alternative “HIT-safe” anticoagulant such as argatroban, danaparoid, bivalirudin, fondaparinux, or a direct oral anticoagulant should generally be started. There is some evidence to support the safety of direct oral anticoagulants for treatment of HIT, but their use for this purpose is still considered off-label, as is that of bivalirudin and fondaparinux (see Clinical Guide: Heparin

, as indicated by symptoms Second, if clinical suspicion of thrombosis Anticoagulation (Note 3) Direct thrombin inhibitors Yes Yes Yes Alternate Direct oral anticoagulants Yes Yes Yes First choice Fondaparinux Yes Yes Yes NR Danaparoid Yes NR Yes NR Heparin Avoid Avoid Avoid Avoid Comment Continue at least 3 months. Continue 3-6 months Ensure tests normal before discontinuing. NR Treatment (Note 2) (Note ) Second (2,000) First PF4 antibody/HIT Second Second NR Second (Note 1) HIPA or SRA (functional test) Third, if available NR — If PF4 positive (Note 6) Imaging First, as indicated by symptoms Second (Note 7) Neuroimaging if headache symptoms First, if indicated Anticoagulation Direct thrombin inhib. Yes Yes — Yes Direct oral anticoag. Yes Yes — Yes Fondaparinux Yes Yes — Discouraged Danaparoid

, bivalirudin, and danaparoid, but also newer agents such as fondaparinux and the direct oral anticoagulants.Total number of panel recommendations: 32What it coversREFERENCECuker, A., Arepally, G. M., Chong, B. H., Cines, D. B., Greinacher, A., Gruel, Y., Linkins, L. A., Rodner, S. B., Selleng, S., Warkentin, T. E., Wex, A., Mustafa, R. A., Morgan, R. L., & Santesso, N. (2018). American Society of Hematology