Exembol® is a selective direct thrombin inhibitor that reversibly inhibits both free and clot-bound thrombin. Anticoagulant effects are produced rapidly with a predictable dose response effect. Exembol® has a short half-life and its anticoagulant effects are rapidly reversible.
Studies have shown that Exembol® is generally well tolerated and improves patient outcomes in HIT. A study of 497 HIT patients demonstrated that Exembol® therapy significantly reduced the risk of new thrombosis and death due to thrombosis in patients with HIT compared to a historical control group. In addition the Exembol® treated patients had a more rapid recovery of platelet count. These benefits were realised without an increased bleeding risk compared with historical control group patients who received standard treatment at that time. Exembol® has also been shown to provide effective anticoagulation in patients with renal dysfunction or failure, conditions often associated with HIT patients in an intensive care unit setting.
The SMC’s decision means that adult patients with suspected or confirmed heparin-induced thrombocytopenia type II (HIT) who require parenteral antithrombotic therapy, will now be able to more readily get access to Exembol® on the NHS in Scotland. Treatment with Exembol® is included in the British Society for Haematology guidelines for patients with HIT.
“HIT is relatively uncommon, but it is a real issue with potentially devastating outcomes for patients,” says Professor Nigel Webster, ICU Physician, Aberdeen. “The SMC guidance represents a therapeutic advance in management of HIT, and Exembol® is a welcome addition to the category.”
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