What are the alternative anticoagulants to hirudin for patients with HIT who have previously been treated with hirudin?
Bivalirudin and argatroban are the alternative anticoagulants to hirudin for patients with HIT who have previously been treated with hirudin. Bivalirudin is a 20-amino acid synthetic polypeptide and an analog of hirudin. It forms a 1:1 stoichiometric complex with thrombin and is licensed as an alternative to heparin for patients undergoing percutaneous interventions for unstable angina or non-ST-elevation or ST-elevation myocardial infarction. Argatroban is a small molecule competitive inhibitor of thrombin and is an alternative to danaparoid for treatment of HIT. It has a shorter half-life compared to danaparoid and does not require an antidote if serious bleeding occurs.