Fixed-dose versus adjusted-dose low molecular weight heparin for the initial treatment of patients with deep venous thrombosis.
Patients with acute deep vein thrombosis (DVT) were treated with a body-weight independent dosage of 2 x 8000 aXa IU low-molecular-weight heparin (LMWH) Certoparin. After the subcutaneous administration of 8000 IU Certoparin, pharmacodynamic parameters did not differ between patients and healthy volunteers, and the AUC of the anticoagulant effects were not related to body weight. Two clinical trials demonstrated a greater regression of thrombi and a lower occurrence of recurrent venous thromboembolism (VTE), major bleeding, and mortality within 14 days of initial therapy compared with intravenous heparin. D-dimer decreased, and anti-Xa activity increased in those patients with a regression of thrombosis. The benefit of the reduced occurrence of recurrent VTE, major bleeding, and mortality was maintained up to 6 months. Major bleeding was not related to the body weight in either treatment group. Treatment of acute DVT in adults with fixed dose of 2 x 8000 aXa IU LMWH Certoparin is more effective and safer than heparin.
Harenberg
Job
J
4th Department of Medicine, University Hospital Mannheim, Ruprecht-Karls University Heidelberg, Mannheim, Germany. j-harenberg@t-online.de
D000925:Anticoagulants / Q000008:administration & dosage* / Q000493:pharmacokinetics; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D007279:Injections, Subcutaneous; D012008:Recurrence; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000188:drug therapy*
D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; D006495:Heparin, Low-Molecular-Weight; C036309:fibrin fragment D; C403769:certoparin