[Treatment of thrombosis with low-molecular-weight heparin. Comparison of body weight-adjusted and fixed dosage].
BACKGROUND
The treatment of deep vein thrombosis (DVT) has been simplified and become safer after introduction of low-molecular-weight heparin (LMWH). The dosage of LMWH was performed by body weight adjustment without dose-finding studies.


METHODS
In three large clinical trials, the improved efficacy and safety of body weight-independent fixed-dose LMWH Certoparin were demonstrated using 2 x 8,000 IU subcutaneously per day for the initial treatment of symptomatic acute DVT. The reduction of thrombus size after 14 days, determined with the Marder score, and the combined endpoint, consisting of recurrent thromboembolism, major bleeding and mortality, was lower over the initial treatment with LMWH compared to intravenous APTT-adjusted unfractionated heparin (UFH). The benefit of the clinical endpoints over 6 months was demonstrated in two clinical trials.


CONCLUSIONS
Treatment of acute DVT is more effective and safer using fixeddose 2 x 8,000 IU Certoparin for the initial treatment compared to UFH.
Harenberg
Job
J
IV. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim. J-Harenberg@t-online.de
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D003627:Data Interpretation, Statistical; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006470:Hemorrhage / Q000139:chemically induced; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010690:Phlebography; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012306:Risk; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology; D013924:Thrombophlebitis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; C403769:certoparin