Exembol: anticoagulant licensed in heparin-induced thrombocytopenia

Exembol (argatroban) is now available in the UK for the treatment of thrombotic disorders in patients with heparin-induced thrombocytopenia.

Argatroban has a short half-life of around 50 minutes and must be given by continuous intravenous infusion
Argatroban has a short half-life of around 50 minutes and must be given by continuous intravenous infusion

PHARMACOLOGY

Argatroban is a parenteral direct thrombin inhibitor that binds reversibly to thrombin. It exerts its anticoagulant effect by inhibiting thrombin-mediated reactions including fibrin formation, platelet aggregation, and the activation of coagulation factors V, VIII and XIII and protein C.1

As argatroban is metabolised in the liver, it can be used patients with renal impairment. However, it is contraindicated in patients with severe hepatic impairment and those undergoing PCI who have any degree of hepatic impairment.1

CLINICAL STUDIES

Two open-label studies evaluated the efficacy and safety of argatroban in a total of 568 patients with heparin-induced thrombocytopenia type II (with or without thrombosis syndrome). Control data were taken from historical studies.2,3

Doses were given by continuous intravenous infusion and were titrated to achieve an activated partial thromboplastin time (aPTT) of 1.5–3 times the baseline aPTT, not exceeding 100 seconds.2,3

In the first study, incidence of the primary endpoint, a composite of new thrombosis and all-cause death or amputation, was significantly reduced in the argatroban group compared with control: 25.6% vs 38.8% (p=0.014). Similar results were observed in the second study.2,3

References:

  1. Exembol Summary of Product Characteristics, May 2011.
  2. Lewis BE et al. Circulation 2001; 103:1838–43.
  3. Lewis BE et al. Arch Intern Med 2003; 163:1849–56.

View Exembol drug record

Further information: Mitsubishi Pharma

Want news like this straight to your inbox?
Sign up for our bulletins

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register
Already registered?
Sign in

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

MIMS Adviser

Especially created for prescribing influencers.

Request free copy

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases