Trial reportCritical care (London, England)2014
Argatroban versus Lepirudin in critically ill patients (ALicia): a randomized controlled trial.
Trial report in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00798525 (Argatroban Versus Lepirudin in Critically Ill Patients - A Randomized Double-blind Trial), which is not on this map. Cited by 11 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Argatroban Versus Lepirudin in Critically Ill Patients - A Randomized Double-blind Trial
Who cites it
11 citing papers in PubMed, 4 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Prognostic factors for patients with heparin-induced thrombocytopenia: a systematic review.International journal of clinical pharmacy · 2021Pooled it
- Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy.The Cochrane database of systematic reviews · 2020Pooled it
- Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy.The Cochrane database of systematic reviews · 2020Pooled it
- Comparisons of argatroban to lepirudin and bivalirudin in the treatment of heparin-induced thrombocytopenia: a systematic review and meta-analysis.International journal of hematology · 2017Pooled it
- Monitoring of argatroban and lepirudin anticoagulation in critically ill patients by conventional laboratory parameters and rotational thromboelastometry - a prospectively controlled randomized double-blind clinical trial.BMC anesthesiology · 2018Trial
- Clinical practice guideline for renal replacement therapy in critically ill patients with acute kidney injury (2026 edition).Journal of intensive medicine · 2026Article
- Superior outcomes with Argatroban for heparin-induced thrombocytopenia: a Bayesian network meta-analysis.International journal of clinical pharmacy · 2021Review
- Recommendations for Therapeutic Apheresis by the Section "Preparative and Therapeutic Hemapheresis" of the German Society for Transfusion Medicine and Immunohematology.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2019Review
- Monitoring of Argatroban and Lepirudin: What is the Input of Laboratory Values in "Real Life"?Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2018Article
- The Evaluation of Pharmacodynamics and Pharmacokinetics of Anti-thrombin DNA Aptamer RA-36.Frontiers in pharmacology · 2017Article
- Argatroban for anticoagulation of a blood salvage system - an ex-vivo study.BMC anesthesiology · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCritically ill patients often require renal replacement therapy accompanied by thrombocytopenia. Thrombocytopenia during heparin anticoagulation may be due to heparin-induced thrombocytopenia with need for alternative anticoagulation. Therefore, we compared argatroban and lepirudin in critically ill surgical patients.
methodsFollowing institutional review board approval and written informed consent, critically ill surgical patients more than or equal to 18 years with suspected heparin-induced thrombocytopenia, were randomly assigned to receive double-blind argatroban or lepirudin anticoagulation targeting an activated Partial Thromboplastin Time (aPTT) of 1.5 to 2 times baseline. In patients requiring continuous renal replacement therapy we compared the life-time of hemodialysis filters. We evaluated in all patients the incidence of bleeding and thrombembolic events.
resultsWe identified 66 patients with suspected heparin-induced thrombocytopenia, including 28 requiring renal replacement therapy. Mean filter lifetimes did not differ between groups (argatroban 32 ± 25 hours (n = 12) versus lepirudin 27 ± 21 hours (n = 16), mean difference 5 hours, 95% CI -13 to 23, P = 0.227). Among all 66 patients, relevant bleeding occurred in four argatroban- versus eleven lepirudin-patients (OR 3.9, 95% CI 1.1 to 14.0, P = 0.040). In the argatroban-group, three thromboembolic events occurred compared to two in the lepirudin group (OR 0.7, 95% CI 0.1 to 4.4, P = 0.639). The incidence of confirmed heparin-induced thrombocytopenia was 23% (n = 15) in our study population.
conclusionsThis first randomized controlled double-blind trial comparing two direct thrombin inhibitors showed comparable effectiveness for renal replacement therapy, but suggests fewer bleeds in surgical patients with argatroban anticoagulation.
trial registrationClinical Trials.gov NCT00798525. Registered 25 November 2008.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.