Current and emerging therapeutics for heparin-induced thrombocytopenia

Heparin-induced thrombocytopenia (HIT) is a prothrombotic complication of heparin therapy. Little more than a decade ago, no effective agents were available to treat this devastating and potentially fatal disease. Since that time, driven by an increased understanding of pathogenesis, the management of HIT has undergone a revolution. Several effective agents for the treatment and prevention of HIT-associated thrombosis are now available. These drugs have transformed the natural history of the disease, dramatically reducing the incidence of thrombosis. Nevertheless, available therapies remain far from ideal. Anticoagulants currently approved for the treatment of HIT are expensive, complex to manage, and carry a substantial bleeding risk. Fortunately, a pipeline of agents await that hold the promise of greater safety, convenience, and cost-effectiveness. The objectives of this review are to discuss currently available drugs for the treatment of HIT, highlight the limitations of these agents, and examine future therapies.