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Rivaroxaban – an oral, direct Factor Xa inhibitor – has potential for the management of patients with heparin‐induced thrombocytopenia
Author(s) -
Walenga Jeanine M.,
Prechel Margaret,
Jeske Walter P.,
Hoppensteadt Debra,
Maddineni Jyothi,
Iqbal Omer,
Messmore Harry L.,
Bakhos Mamdouh
Publication year - 2008
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2008.07300.x
Subject(s) - rivaroxaban , argatroban , fondaparinux , platelet factor 4 , heparin induced thrombocytopenia , heparin , medicine , discovery and development of direct thrombin inhibitors , anticoagulant , pharmacology , low molecular weight heparin , direct thrombin inhibitor , thrombin , platelet , warfarin , dabigatran , thrombosis , atrial fibrillation , venous thromboembolism
Summary Rivaroxaban is an oral, direct activated Factor Xa (FXa) inhibitor in advanced clinical development for the prevention and treatment of thromboembolic disorders. Currently available anticoagulants include unfractionated heparin (UFH) and low molecular weight heparins (LMWHs); however, their use can be restricted by heparin‐induced thrombocytopenia (HIT). HIT is usually caused by the production of antibodies to a complex of heparin and platelet factor‐4 (PF4). This study was performed to evaluate, in vitro , the potential of rivaroxaban as an anticoagulant for the management of patients with HIT. UFH, the LMWH enoxaparin, fondaparinux and the direct thrombin inhibitor argatroban were tested to enable comparative analyses. Rivaroxaban did not cause platelet activation or aggregation in the presence of HIT antibodies, unlike UFH and enoxaparin, suggesting that rivaroxaban does not cross‐react with HIT antibodies. Furthermore, rivaroxaban did not cause the release of PF4 from platelets and did not interact with PF4, unlike UFH and enoxaparin. These findings suggest that rivaroxaban may be a suitable anticoagulant for the management of patients with HIT.