Prospective Evaluation

The results of retrospective studies must be interpreted with caution because the reports are subject to publication bias (studies with "positive" outcomes are more likely to be submitted and accepted for publication than studies with "negative" outcomes). There also was marked heterogeneity among the studies regarding patient eligibility, the methods used to diagnose HIT, the treatment regimens employed, and the monitoring of the response to treatment. For these reasons, a prospective evaluation of fondaparinux efficacy and safety is required. Fondaparinux may have advantages over more established therapies for HIT, including the potential for a lower incidence of major bleeding, easier transition to oral warfarin (if desired),

Day of Fondaparinux Therapy

FIGURE 3 Twenty-two patients with HIT were treated with fondaparinux at (or near) the platelet count nadir following exposure to UFH or LMWH. Platelet count recovery is illustrated by this graph, which compares mean platelet counts for the population. Platelet data have been normalized by subtracting the individual value of the patient's platelet count at first administration of fondaparinux from each preceding and subsequent measurement. Error bars represent one standard deviation from the mean. Abbreviations: UFH, unfractionated heparin; LMWH, low molecular weight heparin; HIT, heparin-induced thrombocytopenia.

Day of Fondaparinux Therapy

FIGURE 3 Twenty-two patients with HIT were treated with fondaparinux at (or near) the platelet count nadir following exposure to UFH or LMWH. Platelet count recovery is illustrated by this graph, which compares mean platelet counts for the population. Platelet data have been normalized by subtracting the individual value of the patient's platelet count at first administration of fondaparinux from each preceding and subsequent measurement. Error bars represent one standard deviation from the mean. Abbreviations: UFH, unfractionated heparin; LMWH, low molecular weight heparin; HIT, heparin-induced thrombocytopenia.

TABLE 4 Emerging and Established Parenteral and Oral Factor Xa Inhibitors3

Agent

Company

Phase

Therapeutic applications evaluated to date

Oral

0 0

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