Fragmin once or twice daily subcutaneously in the treatment of deep venous thrombosis of the leg

Holmström,; Berglund, Margareta; Granquist, S.; Bratt, Göran; Törnebohm, E.; Lockner, D.

doi:10.1016/0049-3848(92)90257-b

Cited by 49 publications

(29 citation statements)

References 6 publications

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“…I Because of their greater bioavailability, low-molecular-weight heparins can be administered subcutaneously without the need for laboratory monitoring. Randomized, controlled trials of treatment for acute deep-vein thrombosis [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] or pulmonary embolism 21 have demonstrated that low-molecular-weight heparins are at least as effective and safe as unfractionated heparin. In addition to the assessments of clinical outcome, repeated venography has revealed a tendency for the thrombus to regress in the groups receiving a low-molecular-weight heparin.…”

mentioning

confidence: 99%

Effects of a Low-Molecular-Weight Heparin on Thrombus Regression and Recurrent Thromboembolism in Patients with Deep-Vein Thrombosis

Breddin¹,

Hach-Wunderle²,

Nakov³

et al. 2001

N Engl J Med

188

111

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mentioning

confidence: 99%

Effects of a Low-Molecular-Weight Heparin on Thrombus Regression and Recurrent Thromboembolism in Patients with Deep-Vein Thrombosis

Breddin¹,

Hach-Wunderle²,

Nakov³

et al. 2001

N Engl J Med

188

111

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“…Initially, most studies comparing LMWH vs. unfractionated heparin in the treatment of VTE used a twice daily regimen [10][11][12]. Once daily administration has lately been compared with a twice daily regimen, and some studies found it to be as effective and safe as twice daily dosing [13][14][15][16][17][18]. Because it seems more convenient for people and may optimize home therapy, the ACCP guidelines on antithrombotic therapy suggested that once daily administration should be preferred over twice daily administration [1].…”

Section: Discussionmentioning

confidence: 99%

Once versus twice daily enoxaparin for the initial treatment of acute venous thromboembolism

Trujillo‐Santos

Bergmann

Bortoluzzi

et al. 2017

Journal of Thrombosis and Haemostasis

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Background In patients with acute venous thromboembolism (VTE), it is uncertain whether enoxaparin should be administered twice or once daily. Methods We used the RIETE Registry data to compare the 15- and 30-day rates of VTE recurrence, major bleeding and death between patients receiving enoxaparin twice daily and those receiving it once daily. We used propensity score matching to adjust for confounding variables. Results The study included 4730 patients: 3786 (80%) received enoxaparin twice daily and 944 once daily. During the first 15 days, patients on enoxaparin once daily had a trend towards more VTE recurrences (odds ratio [OR], 1.79; 95% confidence interval [CI], 0.55-5.88), fewer major bleeds (OR, 0.42; 95% CI, 0.17-1.08) and fewer deaths (OR, 0.32; 95% CI, 0.13-0.78) than those on enoxaparin twice daily. At day 30, patients on enoxaparin once daily had more VTE recurrences (OR, 2.5; 95% CI, 1.03-5.88), fewer major bleeds (OR, 0.40; 95% CI, 0.17-0.94) and fewer deaths (OR, 0.58; 95% CI, 0.33-1.00). On propensity analysis, patients on enoxaparin once daily had fewer major bleeds at 15 (hazard ratio [HR], 0.30; 95% CI, 0.10-0.88) and at 30 days (HR, 0.16; 95% CI, 0.04-0.68) and also fewer deaths at 15 (HR, 0.37; 95% CI, 0.14-0.99) and at 30 days (HR, 0.19; 95% CI, 0.07-0.54) than those on enoxaparin twice daily. Conclusions Our findings confirm that enoxaparin prescribed once daily results in fewer major bleeds than enoxaparin twice daily, as suggested in a meta-analysis of controlled clinical trials.

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“…Clinicians need to keep PE in mind and rule it out, especially for high-risk patients scheduled for any orthopedic surgery, even if preventive prophylactic anticoagulation medication has been administered for a sufficiently long period (based on the instructions for LMWH [e.g., dalteparin sodium 5,000 IU subcutaneously once daily] [17,18]). According to the opti- mal strategies for PE prophylaxis, thromboprophylaxis did not apply to our case, because our patient, lacking any history of venous thoromboembolism, had lower-extremity injuries requiring immobilization [12].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative cardiopulmonary collapse despite prophylactic anticoagulation for thromboembolism

et al. 2018

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Prophylactic anticoagulation for high-risk patients of pulmonary embolism (PE) prevails as acute PE potentially leads to hemodynamic instability resulting in death. Notwithstanding the adequate thromboprophylaxis, rarely, we may face a patient's critical condition with PE. We report here on the patient given intraoperative cardiopulmonary resuscitation that the cause was revealed to be PE despite subcutaneous anticoagulant until the day before scheduled secondary operation. The 72-year-old male patient had already undergone first emergency surgery for right tibia and patella fractures without any problems. Albeit effective, prophylaxis for thromboembolism cannot guarantee PE prevention. With this sobering fact in mind, additionally, early diagnosis and prompt management of PE, especially through interdepartmental coordination, should produce patients' best outcomes.

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Fragmin once or twice daily subcutaneously in the treatment of deep venous thrombosis of the leg

Cited by 49 publications

References 6 publications

Effects of a Low-Molecular-Weight Heparin on Thrombus Regression and Recurrent Thromboembolism in Patients with Deep-Vein Thrombosis

Effects of a Low-Molecular-Weight Heparin on Thrombus Regression and Recurrent Thromboembolism in Patients with Deep-Vein Thrombosis

Once versus twice daily enoxaparin for the initial treatment of acute venous thromboembolism

Intraoperative cardiopulmonary collapse despite prophylactic anticoagulation for thromboembolism

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