Scientific Poster Session III - Original Research

Original Research
  Monday, November 13, 2023
  01:00 PM–02:30 PM

Abstract

Introduction: Heparin-induced thrombocytopenia (HIT) is a prothrombotic disease state that requires initiation of a non-heparin containing anticoagulant for optimal management. Direct oral anticoagulants (DOACs) have become an increasingly popular option for treatment of HIT due to their relative operational ease. However, despite their inclusion in the 2018 American Society of Hematology HIT guidelines, there remains a lack of quality evidence to support their use with existing data based upon small sample sizes.

Research Question or Hypothesis: Are DOACs a safe alternative to warfarin in treatment of acute HIT?

Study Design: Multi-center, retrospective chart review

Methods: Adult patients with a laboratory confirmed or clinical diagnosis of HIT admitted between January 2019-August 2021 who received a DOAC or warfarin were included in this study. The primary outcome was defined as the incidence of a major bleed within 30-days of initiation of therapy. Secondary outcomes included the development of a new thrombus or progression of thrombus and the incidence of minor bleeding.

Results: A total of 46 patients were included in the study. The incidence of major bleed was the same in both groups (1 patient per group). Two patients who received a DOAC developed a new thrombus or progression of thrombus and rates of minor bleeding were similar between the two groups. Patients in the DOAC group were more likely to have normal renal function while warfarin prescribing was more evenly distributed among renal function thresholds.

Conclusion: Major bleeding events were numerically similar between DOACs and warfarin, suggesting a favorable safety profile of DOACs for treatment of HIT. While a larger, prospective study would be ideal, the results of this study do contribute to current literature supporting the use of DOACs for HIT.

Presenting Author

Katherine Rector PharmD
Atrium Health

Authors

Justin Arnall PharmD, BCOP
Levine Cancer Institute

Sandy Lui PharmD
Atrium Health Mercy

Rachel Crawford PharmD, BCPS
Atrium Health Myers Park Internal Medicine