Hirudine zur Behandlung der heparininduzierten Thrombozytopenie und zur Thromboseprophylaxe

Zusammenfassung

Die in Deutschland zugelassenen Indikationen für die rekombinanten Hirudine Lepirudin (Refludan^®) und Desirudin (Revasc^®) sind Therapie der heparininduzierten Thrombozytopenie (HIT) bzw. Thromboseprophylaxe nach knie- oder hüftendoprothetischem Eingriff. Besonderheiten dieser Pharmaka sind ihre stark nierenabhängige Pharmakokinetik und ihre Fähigkeit, gegen Hirudin gerichtete Antikörper zu induzieren. Enges Monitoring der Dosis gestattet jedoch die sichere und effektive Anwendung. Während Lepirudin neben Danaparoid einen festen Platz bei der Behandlung der HIT einnimmt, konnte sich Desirudin zur Thromboseprophylaxe nach knie- oder hüftendoprothetischen Eingriffen bisher nicht durchsetzen.

Summary

Approved indications for the recombinant hirudins lepirudin (Refludan^®) und desirudin (Revasc^®) are therapy of heparin-induced thrombocytopenia (HIT) and thrombosis prophylaxis following knee or hip replacement surgery. Kidney function dependent pharmacokinetics and their capability of inducing antibodies directed against hirudin are characteristic of this class of drugs. However, close dose-monitoring allows safe and effective use of both compounds. While lepirudin is used widely, besides danaparoid, for treatment of HIT, desirudin has not yet been widely accepted for thrombosis prophylaxis following knee or hip replacement surgery.

Schlüsselwörter

HIT - Hirudin - Heparin

Keywords

HIT - heparin - hirudin

• Literatur

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