A Comparative Sudy Comparing Argatroban® IV vs Desirudin SC for Suspected HIT With or Without Thrombosis Syndrome

Phase 4

Terminated

Conditions: Suspected Heparin-Induced Thrombocytopenia

Interventions: Drug: Desirudin or Argatroban®

Registration Number: NCT00787332

Lead Sponsor: Canyon Pharmaceuticals, Inc.

Brief Summary: Compare Clinical Success and Costs in two Arms

Detailed Description: Demonstrate clinical and economic utility between the study Arms.

Recruitment & Eligibility

Status: TERMINATED

Sex: All

Target Recruitment: 16

Inclusion Criteria

Provide written Informed Consent
Be at least 18 years of age.
A suspicion of heparin-induced thrombocytopenia with or without thrombosis syndrome (HIT/TS) due to one of the following clinical scenarios:
1. Patients who are receiving heparin/LMWH or have received heparin/LMWH within the previous 100 days AND one of the following:
  - have a fall in platelet count of > 30% from a baseline prior to heparin/LMWH, OR
  - have a thrombotic event, OR
  - develop skin lesions secondary to subcutaneous heparin (even if the patient is no longer receiving heparin therapy when thrombocytopenia, thrombosis or skin lesions occur).
  Patients with thrombosis or skin lesions need not have concomitant thrombocytopenia to be included.
2. A rapid fall in the platelet count by >30% from baseline within 24 hours after starting heparin/LMWH in patients with suspected exposure to heparin or LMWH in the previous 100 days (e.g. hospitalization or invasive procedure within the past 100 days).
3. In post-operative cardiac surgery patients, development of thrombocytopenia defined as a decrease in platelet count by >30% from the post-operative peak; or patients whose platelet count fails to increase post-operatively (e.g. remains < 100,000 mm3 at Day 4 or later, calendar day of surgery=Day 0).
In patients with the diagnosis of HIT/TS established by a hematology consultant, but in whom the above criteria are not fulfilled, the Investigator should contact the Medical Monitor for consideration of the patient's inclusion in this study (A hematology consult is highly advisable, but not required prior to randomization).

Exclusion Criteria

Confirmed pregnancy (if woman of child-bearing potential- urine or serum pregnancy test).
Patients with suspected or confirmed pulmonary embolism, requiring continued anticoagulation or acute ischemic stroke will be excluded
Cerebrovascular accident within the previous 6 months
Intracranial neoplasm, arteriovenous malformation or aneurysm.
Severe renal insufficiency as determined by measured or estimated creatinine clearance < 30 ml/min.
Known allergy to Argatroban®, Desirudin or hirudin derived drugs, or known sensitivity to any component of the product
Patients receiving recombinant hirudin (e.g. lepirudin) within the previous 6 months prior to enrollment.
Patients receiving >2 doses of fondaparinux for treatment of suspected HIT
Multi-system organ failure or estimated survival of less than 30 days.
Participation in other clinical research studies involving the evaluation of other investigational drugs or devices within 30 days of enrollment
Refusal to undergo blood transfusion should it become necessary
Active bleeding or irreversible coagulation abnormality
Uncontrolled hypertension defined as a blood pressure >180/110 mm Hg.
Patients requiring indwelling mechanical intervention such as left-ventricular assist device, intra-aortic balloon pump, veno-venous ultra filtration, etc.
Severe liver disease and any other disease or condition, which, in the judgment of the Investigator, would place a patient at undue risk by being enrolled in the trial, or cause inability to comply with the trial.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Desirudin	Desirudin or Argatroban®	Patients with suspected HIT without thrombosis syndrome (HIT/TS), randomized to SC Desirudin
Argatroban®	Desirudin or Argatroban®	Patients randomized to IV Argatroban®

Primary Outcome Measures

Name	Time	Method
New Thrombosis, Amputation, Death, Major and Minor Bleeding	30 days

Secondary Outcome Measures

Name	Time	Method

Trial Locations

Locations (24): Maine Medical Center
🇺🇸
Portland, Maine, United States
North Shore University Hospital
🇺🇸
Manhasset, New York, United States
University of South Florida, Tampa General Hospital
🇺🇸
Tampa, Florida, United States
William Beaumont Hospital
🇺🇸
Royal Oak, Michigan, United States
Emory University, Emory Crawford Long Hospital
🇺🇸
Atlanta, Georgia, United States
Cardiothoracic Vascular Surgial Specialists
🇺🇸
Columbus, Ohio, United States
The Ohio State University Medical Center
🇺🇸
Columbus, Ohio, United States
Methodist Hospital
🇺🇸
Houston, Texas, United States
Kaiser Permanente Medical Center
🇺🇸
Honolulu, Hawaii, United States
University of Colorado Health Science Center
🇺🇸
Aurora, Colorado, United States
University of Rochester Medical Center
🇺🇸
Rochester, New York, United States
Washington Regional Cardiac Surgery
🇺🇸
Washington, DC, District of Columbia, United States
Florida Hospital Cardiovascular Research
🇺🇸
Orlando, Florida, United States
Provena St. Joseph's Medical Center
🇺🇸
Joliet, Illinois, United States
Mercy Medical Center
🇺🇸
Sioux City, Iowa, United States
Montefiore Medical Center, Moses Division
🇺🇸
Bronx, New York, United States
St Vincent's Hosptial -Manhattan
🇺🇸
Manhattan, New York, United States
UMDNJ-Robert Wood Johnson Medical School
🇺🇸
New Brunswick, New Jersey, United States
St Mary's Hospital Rochester, Mayo Clinic
🇺🇸
Rochester, Minnesota, United States
Mount Sinai Clinical & Translational Research Institute
🇺🇸
New York, New York, United States
The Cleveland Clinic
🇺🇸
Cleveland, Ohio, United States
Forsyth Regional Medical Center
🇺🇸
Winston-Salem, North Carolina, United States
University of Utah Hospital
🇺🇸
Salt Lake City, Utah, United States
Charleston Area Medical Center
🇺🇸
Charleston, West Virginia, United States