Low molecular weight heparin versus oral anticoagulants in the long-term treatment of deep venous thrombosis

Abstract

The unmonitored subcutaneous administration of nadroparine in fixed daily doses was more effective than oral acenocoumarol with laboratory control adjustment in achieving recanalization of leg thrombi. With nadroparine, there was less late valvular communicating vein insufficiency, and it was at least as efficacious and safe as oral anticoagulants after long-term administration. These results suggest that LMWHs may therefore represent a real therapeutic advance in the long-term management of DVT.

Evaluation of the deep vein recanalisation and function after low molecular weight heparin (calcium nadroparine) therapy of deep vein thrombosis. Preliminary report

“…The issue of selecting the treatment method and secondary prophylaxis in VTE is raised by the authors of few multi-centre studies. They suggest that according to the obtained results, the prolonged use of LMWH in therapeutic doses (up to 3 or even 6 months) in patients with venous thrombosis does not significantly increase the risk of bleeding, and is more beneficial than OAs administered traditionally in the secondary prophylaxis [26][27][28][29]. They emphasise the fact, that patient groups treated with LMWH, in whom the recanalisation of thrombotic veins was relatively quick, reveal lower incidence of valvular incompetence in the form of reflux and venous insufficiency.…”

“…Lopez-Beret et al suggest that low-molecular--weight heparins induce the fibrinolytic mechanisms within the venous endothelium [26]. The issue of selecting the treatment method and secondary prophylaxis in VTE is raised by the authors of few multi-centre studies.…”

“…Nowadays, the ambulatory treatment of VTE is fully accepted by the medical societies of many Western European countries, and is administered to up to 80% of patients with venous thrombosis and 50% of patients with pulmonary embolism [20]. The newly published papers indicate the role of LMWH in the recanalisation of the thrombotic veins and the reduction of valvular incompetence rate, secondary to venous thrombosis [21][22][23][24][25][26][27][28][29].…”

Tratamiento de la trombosis venosa profunda con heparinas de bajo peso molecular: Estudio comparativo con anticoagulación oral

“…Cuatro (6%) pacientes murieron en el grupo de tratamiento con heparinas de bajo peso molecular: Un paciente por cáncer gástrico, un paciente por cáncer de vejiga, un 6 J. L. ALONSO MARTÍNEZ ET AL. TABLA II paciente por infarto agudo de miocardio y un paciente por neumonía.…”

Heparins in cancer-associated venous thrombosis

“…64 In cancer patients who developed VTE, both initial and long-term use of LMWHs seems to be more effective than starting an oral anticoagulant in the second phase of therapy aimed at preventing CAT recurrence. 65 However, it should be noted that no conducted studies (CLOT, 60 Lopez-Beret et al, 66 in a study assessing the use of nadroparin administered twice daily at a body weight-adjusted dose, demonstrated the efficacy and safety of such an approach as well as reduced the incidence of deep vein valvular incompetence after oral anticoagulants, with no impact on VTE recurrence. 66 In the Main-LITE study 67 which enrolled 200 patients with CAT, 100 subjects were treated with tinzaparin at 175 anti-Xa U/kg body weight/d for 3 months, and the other half received classic therapy with UFH in combination with oral anticoagulants for the same period of time.…”