HEADING: Pharmacologie cliniqueArgatroban in heparin-induced thrombocytopenia: A survey of prescribing practices and use in France

Summary Objective.- A survey of prescribing practices was carried out in France to ensure that argatroban was used appropriately during the first 18 months after it obtained marketing authorization for anticoagulation in adults with heparin induced thrombocytopenia (HIT). Methods.- This observational study was proposed to public and private hospitals with at least 2 orders of argatroban. All patients who received at least one argatroban injection during the study period had to be included. Their demographic characteristics, the pathology causing heparin treatment, the indication of treatment with argatroban, as well as available real-life clinical and biological monitoring data were retrospectively collected. Results.- In the 23 participating centers, the drug was prescribed mainly by the following hospital units: surgery and intensive care (79.3%) [of which 18.3% cardiovascular], nephrology/hemodialysis (14.8%) and internal medicine (5.9%). Among the 169 patients included, with median age of 68 years, 118 (69.8%) had renal impairment (creatinine clearance 2µg/kg/min were used during hemodialysis. More than half of the patients (58.6%) had no clinical complications. Most of the serious adverse reactions were hemorrhagic (11 /12). Conclusion.- This study illustrates the complexity of treatment for HIT and the need to be familiar with and follow guidelines on the management of HIT, especially for susceptible patients treated in intensive care units.