Efficacy and Safety of Two Regimens of Low Molecular Weight Heparin Fragment (Fragmin) in Preventing Postoperative Venous Thrombolism

Kakkar, Vijay V.; Kakkar, S.; Sanderson, Ruth; Peers, C.E.

doi:10.1159/000215353

Cited by 23 publications

(20 citation statements)

References 12 publications

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“…These findings were confirmed by Kakkar et al [ 12] who concluded from another study in patients with abdominal surgery that the application of only 2,500 anti-XaU Fragmin is justified and recommendable.…”

Section: Prophylaxis Of Thromboembolism In General Surgerysupporting

confidence: 63%

Prophylaxis of Thromboembolism with Various Low-Molecular-Weight Heparins

Haas¹,

Blümel²

1988

Pathophysiol Haemos Thromb

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In numerous clinical studies, the antithrombotic effect and tolerance of low-molecular-weight heparins (LMWHs) were compared to those of unfractionated heparin (UFH). Based on our own experience and on a review of the literature the following conclusions can be drawn. In the field of prophylaxis of thromboembolism, including high-risk patients with major bone surgery, the antithrombotic efficacy of a single daily dose of LMWH is at least equivalent to two or three injections of UFH per day. It should, however, be noted that the margin between thromboembolic and bleeding complications has not become bigger, although this had been derived from experimental results. In order to avoid bleeding complications, it is absolutely necessary to take note of the manufacturers’ recommendations. This is particularly important when a change of various preparations is considered, because the standardization of LMWH preparations is different and the units are not comparable. The main advantage of LMWH results from an improved practicability. The single daily dose leads to an improved compliance of patients and the nursing staff is spared a great deal of work.

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Section: Prophylaxis Of Thromboembolism In General Surgerysupporting

confidence: 63%

Prophylaxis of Thromboembolism with Various Low-Molecular-Weight Heparins

Haas¹,

Blümel²

1988

Pathophysiol Haemos Thromb

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“…The widely used naturally occurring anticoagulant heparin has several side effects such as development of thrombocytopenia [6,7], hemorrhagic effect [8,9], ineffectiveness in congenital or acquired antithrombin deficiencies, and incapacity to inhibit thrombin bound to fibrin [10,11]. It is extracted from pig intestine or bovine lung, posing a risk of zoonoses and potential ethical issues, highlighting a need for alternative anticoagulant and antithrombotic therapies, especially ones that are orally available.…”

Section: Introductionmentioning

confidence: 99%

Pilot clinical study to evaluate the anticoagulant activity of fucoidan

Irhimeh

Fitton²,

Lowenthal

2009

Blood Coagulation &Amp; Fibrinolysis

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Seaweed-derived heparin-like substances such as fucoidan have been extensively studied in vitro as potential blood anticoagulants. However, there have been no human studies investigating the anticoagulant activity of fucoidan when administered orally. This pilot clinical trial was aimed to assess the safety and clinical effects of fucoidan ingestion on hemostasis as well as study its in-vitro anticoagulant activity. In a single-blinded clinical trial, a total of 20 human volunteers were allocated to both the placebo group (n = 10) who ingested 3 g of guar gum capsules and to the active treatment group (n = 10) who ingested 3 g of 75% fucoidan capsules for 12 days. Platelet indices, activated partial thromboplastin time, antithrombin-III, thrombin time, prothrombin time, and antifactor-Xa were analyzed according to standard methods. In vivo, activated partial thromboplastin time increased from 28.41 to 34.01 s (n = 10, P = 0.01), thrombin time decreased from 18.62 to 17.55 s (n = 10, P = 0.04), and antithrombin-III increased from 113.5 to 117% (n = 10, P = 0.03). The in-vitro fucoidan anticoagulant activity was found prominent. It increased activated partial thromboplastin time, thrombin time, and prothrombin time, whereas antithrombin-III decreased. In-vivo effect of fucoidan on hemostasis was not obvious probably due to low intestinal absorption. Thus, fucoidan in the form used in this study does not seem to have an oral anticoagulant activity, but it has a very strong in-vitro anticoagulant activity.

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“…Kabi 2165 and other LM W heparins have been shown to be effective and safe prepara tions for the prophylaxis of DVT in several groups of immobilized patients when used in doses according to their individual anticoag ulant and bleeding properties [18][19][20][21][22][23]. In general surgical patients (less prone to de velop DVT compared to stroke patients) an effective and safe dose of Kabi 2165 seems to be 2,500 anti-Xa U s.c./24 h [24,25], Turpie et al [26] used LMW heparin ORG10172 in stroke patients to prevent DVT and concluded that treated patients developed less DVT and did not suffer from major bleeding accidents.…”

Section: Discussionmentioning

confidence: 99%

Prophylaxis of Deep Venous Thrombosis with a Low-Molecular-Weight Heparin (Kabi 2165/Fragmin®) in Stroke Patients

Prins¹,

Gelsema

Sing

et al. 1989

Pathophysiol Haemos Thromb

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In a group of 60 patients in the acute phase of an ischemic stroke the assumption that low-molecular-weight heparin Kabi 2165 in the dose of 2 × 2,500 anti-Xa units s.c. could prevent thromboembolic complications was tested using a double-blind, placebo-controlled, randomized trial design. Thirty patients were allocated to each group. Both treatment groups were comparable with regard to neurological status and general condition. In the Kabi 2165 group there were 6 cases of deep venous thrombosis (DVT) compared to 15 in the placebo group (p = 0.05). In the placebo group there were 4 deaths during the trial versus 9 in the Kabi-2165-treated group (NS). Cerebral bleeding complicated 2 cases in the placebo group versus 4 in the Kabi 2165 group (NS). These results indicate that in ischemic stroke patients Kabi 2165 2 × 2,500 anti-Xa units s.c./24 h reduces the frequency of DVT. Because of the small number of patients it is impossible to evaluate the safety.

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Efficacy and Safety of Two Regimens of Low Molecular Weight Heparin Fragment (Fragmin) in Preventing Postoperative Venous Thrombolism

Cited by 23 publications

References 12 publications

Prophylaxis of Thromboembolism with Various Low-Molecular-Weight Heparins

Prophylaxis of Thromboembolism with Various Low-Molecular-Weight Heparins

Pilot clinical study to evaluate the anticoagulant activity of fucoidan

Prophylaxis of Deep Venous Thrombosis with a Low-Molecular-Weight Heparin (Kabi 2165/Fragmin®) in Stroke Patients

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