Comparison of Danaparoid Sodium and Synthetic Protease Inhibitors for the Treatment of Disseminated Intravascular Coagulation Associated with Hematological Malignancies: A Retrospective Analysis

Abstract

<b><i>Background:</i></b> Danaparoid sodium and synthetic protease inhibitors (SPIs) have been approved for the treatment of disseminated intravascular coagulation (DIC) in Japan. <b><i>Objectives:</i></b> To compare the clinical results of the treatment of DIC with danaparoid or SPIs. <b><i>Methods:</i></b> We retrospectively examined 188 patients with hematological malignancy-related DIC. <b><i>Results:</i></b> DIC resolution rate in the danaparoid group was higher than that in the SPIs group (61.5 vs. 42.6%; <i>p</i> = 0.031) on day 7. Multivariate analysis identified the response to chemotherapy as independent predictive factor for DIC resolution on day 7 (odds ratio, OR, 2.28; 95% confidence interval, CI, 1.21–4.31; <i>p</i> = 0.011). While there was no significant difference in the DIC resolution rate on day 14 (75.0 vs. 62.4%; <i>p</i> = 0.117), in a subgroup analysis of patients who did not show an improvement in the underlying disease, the danaparoid group showed a significantly better DIC resolution rate (OR 3.89; 95% CI 1.15–13.2; <i>p</i> = 0.030). There was no difference in the rate of cumulative mortality from bleeding within 28 days between the 2 groups (6.6 vs. 3.3%; <i>p</i> = 0.278). <b><i>Conclusions:</i></b> Danaparoid may be associated with more frequent resolution of DIC in patients with refractory underlying disease.