Low Molecular Weight Heparins (LMWH) in the Treatment of Patients with Acute Venous Thromboembolism

Hirsh, Jack; Siragusa, Sergio; Cosmi, B.; Ginsberg, Jeffrey S.

doi:10.1055/s-0038-1642702

Cited by 66 publications

(56 citation statements)

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“…Heparin and coumadin are proven anticoagulants for acute and chronic thrombotic disorders, respectively. [5][6][7] The most recent novel antithrombotic agent introduced for adjunctive treatment of thrombotic events associated with vascular interventions is abciximab (ReoPro™), an antibody that blocks platelet integrin GPIIb/IIIa (the fibrinogen receptor) and hence, platelet aggregation. 8,9 However, these anticoagulants and the GPIIb/IIIa antagonists may have restricted therapeutic capacity due to significant adverse effects such as bleeding, thrombocytopenia, and need for careful patient monitoring.…”

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confidence: 99%

Antithrombotic Efficacy of a Novel Murine Antihuman Factor IX Antibody in Rats

Feuerstein¹,

Patel²,

Toomey³

et al. 1999

ATVB

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Abstract-A murine antihuman factor IX monoclonal antibody (BC2) has been generated and evaluated for its capacity to prolong the activated partial thromboplastin time (aPTT) in vitro and ex vivo and to prevent arterial thrombosis in a rat model in vivo. BC2 extended aPTT to a maximum of 60 to 80 seconds at 100 to 1000 nmol/L in vitro (rat and human plasma, respectively) and ex vivo (rat) after dosing of rats up to 6 mg/kg in vivo. BC2, administered as bolus (1 to 6 mg/kg) followed by infusion (0.3 to 2 mg ⅐ kg Ϫ1 ⅐ h Ϫ1 ), dose-dependently prevented thrombosis of an injured rat carotid artery (FeCl 3 -patch model), increased time to artery occlusion, and reduced incidence of vessel occlusion. BC2 efficacy in preventing arterial thrombosis exceeded that of heparin (bolus 15 to 120 U/kg followed by infusion 0.5 to 4.0 U ⅐ kg Ϫ1 ⅐ min Ϫ1 ), whereas the latter rendered the blood incoagulable (aPTTϾ1000 seconds). BC2 demonstrated complete antithrombotic efficacy also as a single bolus given either as prevessel or postvessel injury as evidenced by reduction of thrombus mass (from 4.18Ϯ0.49 to 1.80Ϯ0.3 mg, PϽ0.001), increasing vessel patency time (from 14.9Ϯ0.9 minutes to 58.3Ϯ1.7 minutes, PϽ0.001) and decreasing incidence of vessel occlusion from 100% to 0% in vehicle-versus BC2-treated rats, respectively. BC2 (3 mg/kg, IV) administered in a single bolus resulted in 50% reduction in thrombus mass (PϽ0.01), extended vessel patency time (PϽ0.001), extended aPTT only 4-fold, and had no effect on blood loss via a tail surgical wound; heparin, at doses that reduced thrombus mass to a similar extent, extended aPTT beyond 1000 seconds (over 500-fold) and increased blood loss from 1.8Ϯ0.7 to 3.3Ϯ0.6 mL (PϽ0.001). These data suggest that BC2 may provide enhanced therapeutic efficacy in humans at lesser interference with blood hemostasis than heparin.

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mentioning

confidence: 99%

Antithrombotic Efficacy of a Novel Murine Antihuman Factor IX Antibody in Rats

Feuerstein¹,

Patel²,

Toomey³

et al. 1999

ATVB

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“…Comparisons of LMWH and UFH were also performed, and the main results are shown in Figure 4 [12]. These data indicate a 61% clear and significant reduction of thrombo-embolic events in favour Transition (EMT), adhesion and metastatic cell migration through the vascular wall, and proteolysis of surrounding tissue.…”

Section: Introductionmentioning

confidence: 82%

Thrombo-Embolic Events in Cancer Patients with Impaired Renal Function

A¹

2014

J Blood Disord Transfus

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“…The risk of bleeding is increased with an increased heparin dose, but also other factors such as recent surgery, trauma, peptic ulcer, malignancy or an haemostatic abnormality are important. Most tri als comparing SH to LMWH suggest that LMWH 40 Medicine 50(19971 36-45 cause fewer bleeding complications [20,[39][40][41], This embolism despite anticoagulation [8,62,63]. No data is probably due to a lower anti-IIa/anti-Xa ratio of LMWH than of SH.…”

Section: Side-effectsmentioning

confidence: 99%

“…Table 1 shows the different LMWH that are currently registered for treatment of DVT in the Netherlands. Jn conclusion, LMWH seem promising for the initial treatment of DVT and are about to replace intravenous heparin treatment [20], Recently evi dence has been provided that in the future patients with DVT might even be treated with LMWH at home [46,47], Both studies compared treatment with SH (administered in the hospital intravenously) to LMWH. The studies allowed outpatients taking LMWH to go home immediately and hospitalized patients taking LMWH to be discharged early.…”

Section: Low Molecular Weight Heparins (Lmwh)mentioning

confidence: 99%

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New developments in the treatment of deep venous thrombosis

Janssen¹,

Nováková²,

Verbruggen³

et al. 1997

The Netherlands Journal of Medicine

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An initial course of standard heparin (SH) or low-molecular-weight heparins (LMWH) is regarded as the treatment of choice for patients with deep venous thrombosis (DVT). LMWH have better bioavailability after subcutaneous administra tion, have a longer half-life, and show higher and more predictable anticoagulant activity. As a result they can be given subcutaneously and without laboratory control, using a dose that is determined by body weight. Because of these multiple advantages of LMWH they will replace SH in the future and subsequently home treatment with LMWH of selected patients seems feasible. The currently accepted approach is to start with SH or LMWH therapy combined with oral anticoagulant therapy (OAT) at the time of diagnosis. The course of SH or LMWH should continue for at least 5 days, provided that international normalized ratio (INR) is in the therapeutic range on 2 consecutive days. OAT should be continued for at least 3 months to prolong the prothrombin time to an INR of 2 -3 . When oral anticoagulants are either contraindicated or inconvenient, SH or LMWH can be used at the middosing interval. The role of anti-platelet treatment is not yet established 4 and should be compared with coumarin therapy in the future.

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Low Molecular Weight Heparins (LMWH) in the Treatment of Patients with Acute Venous Thromboembolism

Cited by 66 publications

References 0 publications

Antithrombotic Efficacy of a Novel Murine Antihuman Factor IX Antibody in Rats

Antithrombotic Efficacy of a Novel Murine Antihuman Factor IX Antibody in Rats

Thrombo-Embolic Events in Cancer Patients with Impaired Renal Function

New developments in the treatment of deep venous thrombosis

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