argatroban / Generic mfg. - LARVOL DELTA

Double Trouble Heartbreak (ATS 2025) - "His anticoagulation was switched to heparin drip and subsequently argatroban due to Eliquis failure. A cardiac MRI may have better delineated the type of lesion that truly existed on the aortic valve. Regardless, the patient was a poor surgical candidate for repair of either lesion."

Cardiovascular • Diabetes • Gastroenterology • Hepatology • Metabolic Disorders • Oncology • Pain • Pancreatic Adenocarcinoma • Pancreatic Cancer • Respiratory Diseases • Venous Thromboembolism

Diagnostic Challenges Associated With Antibody-Negative, SRA-Positive Heparin-induced Thrombocytopenia: A Case Report (ATS 2025) - "She was started on an Argatroban infusion...This case illustrates the possibility of antibody-negative, SRA-positive HIT. To the authors' knowledge, this is only the third reporting and second case at our institution of antibody-negative, SRA-positive HIT."

Case report • Clinical • Atrial Fibrillation • Cardiovascular • Hematological Disorders • Myocardial Infarction • Thrombocytopenia • Thrombosis

Sepsis and Surgery: A Case of Heparin-induced Thrombocytopenia (ATS 2025) - "Antibiotic treatment with vancomycin and piperacillin-tazobactam was started, as well as venous thromboembolism prophylaxis with subcutaneous heparin...Antibiotic coverage was broadened to meropenem on day five due to persistent leukocytosis...Initially, the rash was attributed to the patient's outpatient carbamazepine, however, there was no improvement in the rash despite discontinuation...Heparin was discontinued and replaced with argatroban...As a result, HIT may represent a misdirected immunologic response to infection. This case demonstrates HIT in a patient with recent surgery and sepsis, with subsequent improvement following discontinuation of heparin and treatment of sepsis."

Clinical • Surgery • Cardiovascular • Hematological Disorders • Hypertension • Infectious Disease • Neuralgia • Pain • Pancreatitis • Septic Shock • Thrombocytopenia • Venous Thromboembolism

Severe Hemodynamic Instability in a Young Pregnant Woman with Massive Pericardial Effusion and Pulmonary Embolism Secondary to Primary Mediastinal Non-Hodgkin's Lymphoma. (PubMed, J Clin Med) - "Systemic anticoagulation was guaranteed by heparin, which shifted to argatroban for heparin resistance. Cytoreductive chemotherapy was initiated with the COMP-R regimen (i.e., cyclophosphamide, vincristine, methotrexate, prednisone, and rituximab), and the patient progressively improved up to ICU and hospital discharge. This case highlights the challenges in managing a complicated patient requiring early multidisciplinary intervention, which was crucial for stabilizing the patient and optimizing fetal and maternal prognosis."

Journal • B Cell Lymphoma • Cardiovascular • Heart Failure • Hematological Malignancies • Hodgkin Lymphoma • Large B Cell Lymphoma • Lymphoma • Non-Hodgkin’s Lymphoma • Oncology • Primary Mediastinal Large B-Cell Lymphoma • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Venous Thromboembolism

Variability of Argatroban Effects on the Multiple APTT Reagents in High and Low Coagulation Activity Samples. (PubMed, Int J Lab Hematol) - "A reactivity difference was observed in argatroban-spiked samples, which increased in abnormal plasma samples. APTT may not reflect the anticoagulant activity of argatroban in patients with abnormal coagulation activity. The reactivity of APTT should be confirmed in each laboratory, and patient background coagulation status should be assessed before monitoring is conducted using the APTT ratio."

Journal

A retrospective review of reduced dose argatroban in liver impairment (EASL 2025) - "In this retrospective study of critically ill patients with liver impairment, a reduced dose of argatroban starting at 0.2mcg/kg/min was effective as an anticoagulant in HIT without significant increase in bleeding events."

Retrospective data • Review • Cardiovascular • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Failure • Novel Coronavirus Disease • Pneumonia • Septic Shock • Thrombocytopenia • Thrombosis

Argatroban in patients with acute ischemic stroke with early neurological deterioration: a cost-effectiveness analysis from the perspective of Chinese healthcare system. (PubMed, Front Pharmacol) - "Scenario analysis confirmed the robustness of these findings across various scenarios. Argatroban is highly cost-effective for Chinese patients with AIS and END from the perspective of the Chinese healthcare system."

HEOR • Journal • Cardiovascular • Ischemic stroke

Effect of Argatroban Plus Dual Antiplatelet in Branch Atherosclerosis Disease: A Randomized Clinical Trial. (PubMed, Stroke) - "Argatroban plus DAPT is a safe and effective strategy to reduce END occurrence and improve 90-day functional outcome in high-risk branch atherosclerosis disease patients. URL: https://www.chictr.org.cn; Unique Identifier: ChiCTR21000 46487."

Clinical • Journal • Atherosclerosis • Cardiovascular • Hematological Disorders • Ischemic stroke

Integration of machine learning and experimental validation reveals new lipid-lowering drug candidates. (PubMed, Acta Pharmacol Sin) - "Clinical data analysis confirmed that four candidate drugs, with Argatroban as the representative, demonstrated lipid-lowering effects...Molecular docking and dynamics simulations elucidated the binding patterns and stability of candidate drugs in interaction with related targets. We successfully identified multiple non-lipid-lowering drugs with lipid-lowering potential by integrating state-of-the-art machine learning techniques with multi-level validation methods, thereby providing new insights into lipid-lowering drugs, establishing a paradigm for AI-based drug repositioning research, and expanding the repertoire of lipid-lowering medications available to clinicians."

Journal • Cardiovascular • Dyslipidemia

Trousseau Syndrome-Associated Acute Multifocal Cerebral Infarction: When Triple-Pathway Antithrombotic Therapy Overcomes Low Molecular Weight Heparin Resistance. (PubMed, Cureus) - "The initial infusion of nadroparin, which was co-administered with aspirin, achieved almost no anticoagulation. Consequently, the strategy was escalated to triple-pathway antithrombotic therapy through substitution with argatroban, clopidogrel, and cilostazol. This regimen successfully prevented further thrombotic complications. This case provides rare documentation of catastrophic cerebral parenchymal involvement secondary to TS. Furthermore, the effective application of anticoagulation-antiplatelet combination therapy following low-molecular-weight heparin (LMWH) resistance offers a potential management paradigm for refractory hypercoagulable states."

Journal • Atherosclerosis • Cardiovascular • CNS Disorders • Hematological Disorders • Hepatocellular Cancer • Oncology • Solid Tumor • Thrombosis

Intravenous Methylprednisolone for Acute Right Middle Cerebral Artery Occlusion in Granulomatosis Polyangiitis: A Case Report. (PubMed, Intern Med) - "A 17-year-old Japanese woman diagnosed with granulomatosis with polyangiitis (GPA) and was treated with immunotherapy suddenly developed an impaired consciousness, left hemiplegia, and conjugate eye deviation to the right. Aspirin and argatroban dissolved the residual thrombi. A combination of IVMP and antithrombotic therapy may be effective for large-vessel occlusions associated with GPA."

Journal • CNS Disorders • Rare Diseases • Strabismus • Vasculitis

End Stage Heart Failure in Systemic Sclerosis- From Mechanical Circulatory Support to Heart Transplant (ISHLT 2025) - "Despite the administration of argatroban infusion, which provided adequate systemic anticoagulation, a follow-up CT scan revealed the presence of multiple thrombotic deposits on the non-coronary cusp of the aortic valve, the left atrial in-flow cannula, a non-occlusive pulmonary embolism, and splenic infarction, as a consequence of persistent VF for a period of 50 days...During the post-transplant period, he developed acute necrotizing pancreatitis, which was managed conservatively. Following a period of 119 days of ICU treatment, the patient was transferred to the Cardiology Ward in fit and well condition.Summary Considering the clinical interactions between the chronic systemic autoimmune disease, mid-term mechanical circulatory support, 50 consecutive days of VF and associated pro-thrombotic complications the OHT can be a viable option in SSc complicated with end-stage heart failure."

Cardiovascular • Congestive Heart Failure • Heart Failure • Immunology • Pancreatitis • Pulmonary Embolism • Respiratory Diseases • Scleroderma • Systemic Sclerosis • Transplantation • Ventricular Tachycardia

Anticoagulants in Children with Renal Impairment: A Narrative Review. (PubMed, Semin Thromb Hemost) - "These factors, combined with limited data, can make managing anticoagulation in children with renal impairment a challenge. Therefore, the focus of this review will be to describe the pharmacokinetics of the following anticoagulants in children with impaired renal function: unfractionated heparin, enoxaparin, dalteparin, rivaroxaban, apixaban, edoxaban, fondaparinux, bivalirudin, argatroban, dabigatran, and warfarin."

Journal • Cardiovascular • Nephrology • Renal Disease • Venous Thromboembolism

Impact of Reactant Dissolution in the Kinetics of a Catalytic Hydrogenation for the Production of Argatroban. (PubMed, Org Process Res Dev) - "A refined first-principles model, incorporating the effect of the catalyst amount on the dissolution mass transfer coefficient, significantly improved the accuracy of dissolution predictions and enabled better identification of the intrinsic reaction kinetics. The addition of a microkinetic description further improved the predictions of intermediates and products."

Journal

Anticoagulation Management During ECMO: Narrative Review. (PubMed, JHLT Open) - "Direct thrombin inhibitors, such as bivalirudin, are valuable alternatives, particularly for patients with heparin-induced thrombocytopenia (HIT), though their cost and availability remain barriers...Anticoagulation management in ECMO continues to evolve, focusing on individualized approaches, improved monitoring, and better outcomes. Standardized protocols and further research are essential for optimizing care in this high-risk population."

Journal • Review • Cardiovascular • Congestive Heart Failure • Heart Failure • Hematological Disorders • Thrombocytopenia • Thrombosis

A case of heparin-induced thrombocytopenia (HIT) developing into seizure and respiratory arrest caused by continuous intravenous heparin infusion for multiple cerebral infarcts (PubMed, Rinsho Shinkeigaku) - "We suspected heparin-induced thrombosis (HIT), and therefore changed heparin treatment to argatroban, following which the thrombi disappeared immediately. As was observed in our patient, spontaneous HIT without recent exposure to heparin can occur in rare circumstances; as such, heparin treatment should be administered with caution. As mechanical thrombectomy is usually performed under heparinization, it is important to consider the risk of HIT in cases of new thrombi during thrombectomy."

Journal • Cardiovascular • CNS Disorders • Epilepsy • Hematological Disorders • Hypertension • Thrombocytopenia • Thrombosis

Comparison of Local and Centrally Adjudicated Modified Rankin Scale Scores in the MOST Trial. (PubMed, Stroke) - P3 | "MOST was a phase 3, single-blind, randomized trial evaluating argatroban, eptifibatide, or placebo in addition to intravenous thrombolysis. With blinded end point assessments, central mRS adjudication in acute stroke trials may not be necessary. URL: https://www.clinicaltrials.gov; Unique identifier: NCT03735979."

Journal • Cardiovascular • Infectious Disease • Ischemic stroke • Novel Coronavirus Disease • Respiratory Diseases

Heparin-Induced Thrombocytopenia and Portal Vein Thrombosis in Patients With Hepatocellular Carcinoma After Hepatectomy: A Case Report. (PubMed, Cureus) - "We stopped the heparin and started the argatroban administration. The platelet level increased to the normal range, and the D-dimer level decreased. After the reduction of portal vein and pulmonary thrombosis, she was discharged from the hospital on postoperative day 28."

Journal • Cardiovascular • Fibrosis • Gastroenterology • Hematological Disorders • Hepatocellular Cancer • Hepatology • Hypertension • Immunology • Liver Cancer • Liver Cirrhosis • Oncology • Pulmonary Embolism • Respiratory Diseases • Solid Tumor • Thrombocytopenia • Thrombosis • AFP

In vitro Assessment of Drug Adsorption Profiles During Hemoadsorption Therapy. (PubMed, Blood Purif) - "The findings indicate considerable differences in the adsorption of the tested drugs and should be confirmed by additional in vivo studies with careful monitoring of drug levels throughout the course of therapy.Understanding the in vivo dynamics is crucial for adjusting dosages appropriately during hemoadsorption use to ensure therapeutic efficacy and patient safety."

Journal • Preclinical • Infectious Disease • Inflammation • Septic Shock

Perturbation-Modulated Native Mass Spectrometry Excludes a Nonspecific Drug Target Protein Binder Based on Conformation Stability Change. (PubMed, Anal Chem) - "The approach was applied to screening assays of two drug target proteins, thrombin and dihydrofolate reductase, revealing that for thrombin, fluvastatin may share the same binding site as argatroban, which is supported by competition experiments and molecular docking results. These results provide new insights into the anticoagulation effect of statins and show the potential of the approach in prioritizing candidates for target proteins."

Journal • DHFR

Diagnostic Challenges and Associated Morbidity with Antibody-Negative, SRA-Positive Heparin-Induced Thrombocytopenia: A Case Report. (IARS-SOCCA 2025) - "While on argatroban, the patient underwent revascularization but required an additional revision for stent re-thrombosis... While the SRA remains the gold standard for HIT diagnosis, many providers utilize a PF4 antibody to rule out HIT given its remarkably high accuracy and quicker time to result. This case illustrates the non-zero possibility of antibody-negative, SRA-positive HIT, along with its associated morbidity. To the authors' knowledge, this is only the second reporting of antibody-negative, SRA-positive HIT to-date [5]."

Case report • Clinical • Cardiovascular • Hematological Disorders • Myocardial Infarction • Thrombocytopenia • Thrombosis

Plasmapheresis for Management of Heparin-Induced Thrombocytopenia to Facilitate Urgent Operative Intervention with Cardiopulmonary Bypass (IARS-SOCCA 2025) - "At that time, he was transitioned to argatroban, and the SRA resulted positive for HIT. There is limited research regarding the utility of plasmapheresis for patients requiring urgent CPB where heparin use is mandated. Bivalrudin, a commonly used alternative for patients with HIT, is not currently approved by the Food and Drug Administration for use during CPB in the United States. The Clinical Practice Guidelines for Anticoagulation during Cardiopulmonary Bypass give a class IIa recommendation to use bivalirudin in place of heparin in patients with HIT, but there is a concern for increased intra- and postoperative bleeding risk with its use."

Cardiovascular • Hematological Disorders • Myocardial Infarction • Nephrology • Renal Disease • Respiratory Diseases • Thrombocytopenia • Thrombosis

Adjunctive Argatroban Therapy in Patients with Acute Ischemic Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials (AAN 2025) - "Adjunctive Argatroban therapy is not superior to standard therapy or placebo and has a higher incidence of at least one adverse outcome."

Retrospective data • Review • Cardiovascular • Ischemic stroke

Consent Deviations in an Acute Ischemic Stroke Clinical Trial (AAN 2025) - "Objective:To compare informed consent protocol deviations (PDs) using conventional paper informed consent documents (ICDs) versus electronic informed consent (eConsent) in the MOST (Multi-arm Optimization of Stroke Thrombolysis) trial.Background:MOST was an NIH-funded, multicenter, randomized controlled trial of intravenous thrombolysis plus integrilin/argatroban/placebo for acute ischemic stroke. eConsent use may reduce some of the common consent PDs. Missing/incorrect HIPAA forms were the most common PD."

Clinical • Cardiovascular • Ischemic stroke

Argatroban and Menadione exert protective effects in ultraviolet-irradiated skin inflammation: A transcriptomic analysis based on identification of iron overload related biomarkers. (PubMed, Int Immunopharmacol) - "Two small molecule drugs targeting SAT1, namely Argatroban and Menadione, were predicted. Moreover, their therapeutic potentials in the treatment of UV-irradiated skin injury were confirmed experimentally."

Biomarker • Journal • Dermatitis • Hematological Disorders • Inflammation • Oncology • RBMS1 • SAT1