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Comparison of Danaparoid Sodium and Synthetic Protease Inhibitors for the Treatment of Disseminated Intravascular Coagulation Associated with Hematological Malignancies: A Retrospective Analysis.
Acta Haematol 2019; :1-10AH

Abstract

BACKGROUND

Danaparoid sodium and synthetic protease inhibitors (SPIs) have been approved for the treatment of disseminated intravascular coagulation (DIC) in Japan.

OBJECTIVES

To compare the clinical results of the treatment of DIC with danaparoid or SPIs.

METHODS

We retrospectively examined 188 patients with hematological malignancy-related DIC.

RESULTS

DIC resolution rate in the danaparoid group was higher than that in the SPIs group (61.5 vs. 42.6%; p = 0.031) on day 7. Multivariate analysis identified the response to chemotherapy as independent predictive factor for DIC resolution on day 7 (odds ratio, OR, 2.28; 95% confidence interval, CI, 1.21-4.31; p = 0.011). While there was no significant difference in the DIC resolution rate on day 14 (75.0 vs. 62.4%; p = 0.117), in a subgroup analysis of patients who did not show an improvement in the underlying disease, the danaparoid group showed a significantly better DIC resolution rate (OR 3.89; 95% CI 1.15-13.2; p = 0.030). There was no difference in the rate of cumulative mortality from bleeding within 28 days between the 2 groups (6.6 vs. 3.3%; p = 0.278).

CONCLUSIONS

Danaparoid may be associated with more frequent resolution of DIC in patients with refractory underlying disease.

Authors+Show Affiliations

Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.Department of Biochemistry, Jichi Medical University, Tochigi, Japan.Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan, ycanda-tky@umin.ac.jp. Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan, ycanda-tky@umin.ac.jp.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31461700

Citation

Minakata, Daisuke, et al. "Comparison of Danaparoid Sodium and Synthetic Protease Inhibitors for the Treatment of Disseminated Intravascular Coagulation Associated With Hematological Malignancies: a Retrospective Analysis." Acta Haematologica, 2019, pp. 1-10.
Minakata D, Fujiwara SI, Hayakawa J, et al. Comparison of Danaparoid Sodium and Synthetic Protease Inhibitors for the Treatment of Disseminated Intravascular Coagulation Associated with Hematological Malignancies: A Retrospective Analysis. Acta Haematol. 2019.
Minakata, D., Fujiwara, S. I., Hayakawa, J., Nakasone, H., Ikeda, T., Kawaguchi, S. I., ... Kanda, Y. (2019). Comparison of Danaparoid Sodium and Synthetic Protease Inhibitors for the Treatment of Disseminated Intravascular Coagulation Associated with Hematological Malignancies: A Retrospective Analysis. Acta Haematologica, pp. 1-10. doi:10.1159/000501818.
Minakata D, et al. Comparison of Danaparoid Sodium and Synthetic Protease Inhibitors for the Treatment of Disseminated Intravascular Coagulation Associated With Hematological Malignancies: a Retrospective Analysis. Acta Haematol. 2019 Aug 28;1-10. PubMed PMID: 31461700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Danaparoid Sodium and Synthetic Protease Inhibitors for the Treatment of Disseminated Intravascular Coagulation Associated with Hematological Malignancies: A Retrospective Analysis. AU - Minakata,Daisuke, AU - Fujiwara,Shin-Ichiro, AU - Hayakawa,Jin, AU - Nakasone,Hideki, AU - Ikeda,Takashi, AU - Kawaguchi,Shin-Ichiro, AU - Toda,Yumiko, AU - Ito,Shoko, AU - Ochi,Shin-Ichi, AU - Nagayama,Takashi, AU - Mashima,Kiyomi, AU - Umino,Kento, AU - Nakano,Hirofumi, AU - Yamasaki,Ryoko, AU - Morita,Kaoru, AU - Kawasaki,Yasufumi, AU - Sugimoto,Miyuki, AU - Ishihara,Yuko, AU - Yamamoto,Chihiro, AU - Ashizawa,Masahiro, AU - Hatano,Kaoru, AU - Sato,Kazuya, AU - Oh,Iekuni, AU - Ohmine,Ken, AU - Muroi,Kazuo, AU - Ohmori,Tsukasa, AU - Kanda,Yoshinobu, Y1 - 2019/08/28/ PY - 2019/01/08/received PY - 2019/06/28/accepted PY - 2019/8/29/entrez PY - 2019/8/29/pubmed PY - 2019/8/29/medline KW - Danaparoid sodium KW - Disseminated intravascular coagulation KW - Gabexate mesilate KW - Hematological malignancy KW - Nafamostat mesilate KW - Synthetic protease inhibitors SP - 1 EP - 10 JF - Acta haematologica JO - Acta Haematol. N2 - BACKGROUND: Danaparoid sodium and synthetic protease inhibitors (SPIs) have been approved for the treatment of disseminated intravascular coagulation (DIC) in Japan. OBJECTIVES: To compare the clinical results of the treatment of DIC with danaparoid or SPIs. METHODS: We retrospectively examined 188 patients with hematological malignancy-related DIC. RESULTS: DIC resolution rate in the danaparoid group was higher than that in the SPIs group (61.5 vs. 42.6%; p = 0.031) on day 7. Multivariate analysis identified the response to chemotherapy as independent predictive factor for DIC resolution on day 7 (odds ratio, OR, 2.28; 95% confidence interval, CI, 1.21-4.31; p = 0.011). While there was no significant difference in the DIC resolution rate on day 14 (75.0 vs. 62.4%; p = 0.117), in a subgroup analysis of patients who did not show an improvement in the underlying disease, the danaparoid group showed a significantly better DIC resolution rate (OR 3.89; 95% CI 1.15-13.2; p = 0.030). There was no difference in the rate of cumulative mortality from bleeding within 28 days between the 2 groups (6.6 vs. 3.3%; p = 0.278). CONCLUSIONS: Danaparoid may be associated with more frequent resolution of DIC in patients with refractory underlying disease. SN - 1421-9662 UR - https://www.unboundmedicine.com/medline/citation/31461700/Comparison_of_Danaparoid_Sodium_and_Synthetic_Protease_Inhibitors_for_the_Treatment_of_Disseminated_Intravascular_Coagulation_Associated_with_Hematological_Malignancies:_A_Retrospective_Analysis L2 - https://www.karger.com?DOI=10.1159/000501818 DB - PRIME DP - Unbound Medicine ER -