Fondaparinux versus enoxaparin for the prevention of venous thromboembolism.
Venous thromboembolism is a frequent, life-threatening, postoperative complication of hip-fracture and total-knee-replacement surgery. Fondaparinux is a synthetic polysaccharide that selectively binds to antithrombin, the primary endogenous regulator of blood coagulation. Low molecular weight heparins, such as enoxaparin, are less specific inhibitors of coagulation. In patients undergoing hip-fracture surgery, fondaparinux is more effective than once-daily enoxaparin as prophylaxis for venous thromboembolism. Fondaparinux (25 mg/day sc.) was also more effective than enoxaparin (30 mg sc. b.i.d.) as prophylaxis for venous thromboembolism in elective knee surgery. These differences may be explained by the fact that there is less prophylaxis cover with enoxaparin, as it has a much shorter duration of action than fondaparinux. Thus, with the present dosing regimens, fondaparinux is probably preferable to enoxaparin for the prevention of venous thromboembolism.
Doggrell
Sheila A
SA
Department of Physiology and Pharmacology, School of Biomedical Sciences, The University of Queensland, QLD 4072, Australia. s_doggrell@yahoo.com
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D017984:Enoxaparin / Q000627:therapeutic use*; D000077425:Fondaparinux; D006801:Humans; D011134:Polysaccharides / Q000627:therapeutic use*; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000209:etiology; D013923:Thromboembolism / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000209:etiology
D017984:Enoxaparin; D011134:Polysaccharides; D000077425:Fondaparinux