The most recent paper I know (see abstract at the link) show that among 209 patients with heparin-induced thrombocytopenia (HIT) 53 patients developed 78 thromboembolic complications with pulmonary embolism representing 16.7% of the cases (that is Less that 50% of the incidence of deep vein thrombosis (39.7%). However no information about the type of heparins used are given. 

However this year an updated review about the incidence of HIT in patients treated with unfractionated heparin (UFH) vs low molecular weight heparins (LMWH) has been published in the Cochrane Database Systematic Reviews (see link). This paper clearly show that the use of LMWHs is associated with a significantly reduced incidence of HIT vs UFH. However too few data are available to draw conclusions about possible differences between LMWHs. 

If I can add a personal comment, I think that given the low incidence of HIT following treatment with LMWHs is can be very difficult to obtain sample sizes large enough to detects statistically significant differences among them. Finally the different incidence of HIT depending on medical condition would further increase the variability.

https://www.ncbi.nlm.nih.gov/pubmed/28544026

https://www.ncbi.nlm.nih.gov/pubmed/28431186

Thanks a lot M. Sardina for excellent answer,

as for me is open question for using Fondaparinux in those patients instead LMWHs. In case of Thrombocytopenia in patients with acute coronary syndrome we use Fondaparinux, despite Thrombocytopenia (3%) and Thrombocytopenia with thrombosis that manifested similarly to HIT in Fondaparinux. One more contraindications for Fondaparinux - Platelets

Dear Sergey, I missed your question!! Sorry about that.. Attached the most recent paper I know that is probably the largest study investigating the use of fondaparinux for the treatment of HIT.  I hope this at least in part may address your question.

Thanks a lot for your answer. I need time to read article. After that I will be comment.

Dear Sergey,

experimental data regarding DOACs in the treatment of patients are still scarce (please see for example this Canadian study with rivaroxaban at https://www.ncbi.nlm.nih.gov/pubmed/27061271).

However, in my opinion, DOACs with studies of single-drug approach in the treatment of venous thromboembolism (VTE; namely, apixaban and rivaroxaban) should become the first choice for patients with HIT or a history of HIT. Warfarin, dabigatran, and edoxaban can be safely administrated to patients with HIT. However, even if it seems reasonable to prolong anticoagulant therapy indefinitely in patients recovering from an episode of HIT, the astute physician knows that many patients will, sooner or later, undergo to a temporary or prolonged interruption of anticoagulant therapy (for invasive procedures, surgery, bleeding, adverse events and so on). Such patients are at increased risk of VTE recurrence, should not receive heparin prophylaxis and, more important, should not be treated with heparins for a VTE recurrence. So, apixaban and rivaroxaban, who do not require any heparin dose, should be the best choice for HIT patients. While waiting for experimental evidence, this remains only my opinion, of course.

Dear M. Sardina,

based on available data LMVHs is associated with a significantly reduced incidence of HIT vs UFH. Fondaparinux is as effective as danaparoid or argatroban to prevent thrombotic events, probably with a similar safety profile. But not inferiority based on result "Fondaparinux for the treatment of suspected heparin-induced thrombocytopenia: a propensity score–matched study" compare todanaparoid or argatroban. My choice - fondaparinux.

Dear Marco,

I completely agree with you. I think that rivaroxaban and apixaban, who do not require any heparin dose, should be the best choice for HIT patients. But we need future RCT to confirm our hypothesis according evidence based medicine.

There are little data on the efficacy of new oral anticoagulants (NOAC) in this setting.

Opinion of Jessica W. Skelley and co-author: NOACs have been considered as potential alternatives to traditional agents based on their pharmacologic activity. Case reports have indicated positive results in patients, with clinical outcomes and tolerability supporting the use of the NOACs as alternative agents in the treatment of HIT. Positive results have been reported for the use of NOACs in the treatment of HIT.

https://www.ncbi.nlm.nih.gov/pubmed/27102287

Hi,

dr Warkentin has published on the current issue of Blood an updated Hamilton experience with DOACs in HIT patients:

http://www.bloodjournal.org/content/130/9/1104?rss=1&sso-checked=true

Thanks a lot, good review Direct oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review.

It is helpful.