Incidence and Nature of Heparin-induced Skin Lesions in Medical Patients

NCT ID: NCT00510432

Last Updated: 2009-08-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2007-04-30

Study Completion Date

2009-01-31

Brief Summary

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An increased number of patients with heparin-induced skin lesions is reported in the literature. Heparin-induced skin lesions may result from either occlusion of cutaneous vessels in patients suffering from autoimmune HIT or from a type IV allergic reaction (delayed type hypersensitivity (DTH) response). However, the incidence and nature of heparin-induced skin lesions has not been determined in a prospective investigation.

To address this open issue is the goal of this ongoing, so far monocenter, clinical investigation.

Detailed Description

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Conditions

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Allergy

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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s.c. anticoagulant therapy

All patients with s.c. anticoagulant therapy (UFH, LMWH, heparinoids, fondaparinux)

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* age \> 18 Y.
* s.c. anticoagulant therapy \>6 days

Exclusion Criteria

* history of HIT
* history of DTH to heparin
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Johann Wolfgang Goethe University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Johann Wolfgang Goethe University Hospitals

Principal Investigators

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Ralf J Ludwig, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Dermatology - Clinic of the Johann Wolfgang Goethe University

Locations

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Department of Dermatology - Clinic of the Johann Wolfgang Goethe University

Frankfurt am Main, Hesse, Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Ralf J Ludwig, MD

Role: CONTACT

+49-69-6301- ext. 6162

Wolf-Henning Boehncke, Professor

Role: CONTACT

+49-69-6301- ext. 5143

Facility Contacts

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Ralf J Ludwig, MD

Role: primary

+49-69-6301- ext. 6162

Marc Schindewolf, MD

Role: backup

+49-69-6301- ext. 5444

References

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Jappe U. Allergy to heparins and anticoagulants with a similar pharmacological profile: an update. Blood Coagul Fibrinolysis. 2006 Nov;17(8):605-13. doi: 10.1097/01.mbc.0000198992.18384.5a.

Reference Type BACKGROUND
PMID: 17102645 (View on PubMed)

Ludwig RJ, Schindewolf M, Utikal J, Lindhoff-Last E, Boehncke WH. Management of cutaneous type IV hypersensitivity reactions induced by heparin. Thromb Haemost. 2006 Nov;96(5):611-7.

Reference Type BACKGROUND
PMID: 17080218 (View on PubMed)

Bircher AJ, Harr T, Hohenstein L, Tsakiris DA. Hypersensitivity reactions to anticoagulant drugs: diagnosis and management options. Allergy. 2006 Dec;61(12):1432-40. doi: 10.1111/j.1398-9995.2006.01227.x.

Reference Type BACKGROUND
PMID: 17073874 (View on PubMed)

Ludwig RJ, Schindewolf M, Alban S, Kaufmann R, Lindhoff-Last E, Boehncke WH. Molecular weight determines the frequency of delayed type hypersensitivity reactions to heparin and synthetic oligosaccharides. Thromb Haemost. 2005 Dec;94(6):1265-9. doi: 10.1160/TH05-05-0318.

Reference Type BACKGROUND
PMID: 16411404 (View on PubMed)

Warkentin TE, Roberts RS, Hirsh J, Kelton JG. Heparin-induced skin lesions and other unusual sequelae of the heparin-induced thrombocytopenia syndrome: a nested cohort study. Chest. 2005 May;127(5):1857-61. doi: 10.1378/chest.127.5.1857.

Reference Type BACKGROUND
PMID: 15888871 (View on PubMed)

Maetzke J, Hinrichs R, Schneider LA, Scharffetter-Kochanek K. Unexpected delayed-type hypersensitivity skin reactions to the ultra-low-molecular-weight heparin fondaparinux. Allergy. 2005 Mar;60(3):413-5. doi: 10.1111/j.1398-9995.2005.00695.x. No abstract available.

Reference Type BACKGROUND
PMID: 15679737 (View on PubMed)

Gaigl Z, Pfeuffer P, Raith P, Brocker EB, Trautmann A. Tolerance to intravenous heparin in patients with delayed-type hypersensitivity to heparins: a prospective study. Br J Haematol. 2005 Feb;128(3):389-92. doi: 10.1111/j.1365-2141.2004.05321.x.

Reference Type BACKGROUND
PMID: 15667543 (View on PubMed)

Hirsch K, Ludwig RJ, Lindhoff-Last E, Kaufmann R, Boehncke WH. Intolerance of fondaparinux in a patient allergic to heparins. Contact Dermatitis. 2004 Jun;50(6):383-4. doi: 10.1111/j.0105-1873.2004.0350j.x. No abstract available.

Reference Type BACKGROUND
PMID: 15274739 (View on PubMed)

Koch P. Delayed-type hypersensitivity skin reactions due to heparins and heparinoids. Tolerance of recombinant hirudins and of the new synthetic anticoagulant fondaparinux. Contact Dermatitis. 2003 Dec;49(6):276-80. doi: 10.1111/j.0105-1873.2003.0255.x.

Reference Type BACKGROUND
PMID: 15025697 (View on PubMed)

Ludwig RJ, Beier C, Lindhoff-Last E, Kaufmann R, Boehncke WH. Tolerance of fondaparinux in a patient allergic to heparins and other glycosaminoglycans. Contact Dermatitis. 2003 Sep;49(3):158-9. doi: 10.1111/j.0105-1873.2003.0185a.x. No abstract available.

Reference Type BACKGROUND
PMID: 14678213 (View on PubMed)

Warkentin TE, Sheppard JA, Sigouin CS, Kohlmann T, Eichler P, Greinacher A. Gender imbalance and risk factor interactions in heparin-induced thrombocytopenia. Blood. 2006 Nov 1;108(9):2937-41. doi: 10.1182/blood-2005-11-012450. Epub 2006 Jul 20.

Reference Type BACKGROUND
PMID: 16857993 (View on PubMed)

Schindewolf M, Scheuermann J, Kroll H, Marzi I, Kaufmann R, Boehncke WH, Ludwig RJ, Lindhoff-Last E. Application, tolerance and safety of fondaparinux therapy in a German hospital: a prospective single-centre experience. Thromb Res. 2012 Jan;129(1):17-21. doi: 10.1016/j.thromres.2011.06.008. Epub 2011 Jul 7.

Reference Type DERIVED
PMID: 21741076 (View on PubMed)

Schindewolf M, Scheuermann J, Kroll H, Garbaraviciene J, Hecking C, Marzi I, Wolter M, Kaufmann R, Boehncke WH, Lindhoff-Last E, Ludwig RJ. Low allergenic potential with fondaparinux: results of a prospective investigation. Mayo Clin Proc. 2010 Oct;85(10):913-9. doi: 10.4065/mcp.2010.0346. Epub 2010 Sep 15.

Reference Type DERIVED
PMID: 20843983 (View on PubMed)

Schindewolf M, Schwaner S, Wolter M, Kroll H, Recke A, Kaufmann R, Boehncke WH, Lindhoff-Last E, Ludwig RJ. Incidence and causes of heparin-induced skin lesions. CMAJ. 2009 Oct 13;181(8):477-81. doi: 10.1503/cmaj.081729. Epub 2009 Sep 28.

Reference Type DERIVED
PMID: 19786468 (View on PubMed)

Related Links

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http://www.gefaesszentrum-frankfurt.de

Homepage of the Department of Internal Medicine (Angiology) with contact persons in the angiology department listed (site in German)

Other Identifiers

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16/07

Identifier Type: -

Identifier Source: org_study_id

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