title: Idraparinux or idrabiotaparinux for long-term venous thromboembolism treatment: a systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a prevalent disease with potential serious consequences. Idraparinux and idrabiotaparinux are two kinds of long-acting pentasaccharides. Evidence has shown that idraparinux and idrabiotaparinux are effective anticoagulants. However, up to now, there is no consensus on whether they are better than other anticoagulation methods for long-term VTE treatment.
  
  
  OBJECTIVE
  To evaluate the effect of idraparinux or idrabiotaparinux versus other anticoagulation methods for long-term VTE treatment.
  
  
  METHODS
  We searched Cochrane Central Register of Controlled Trials, PubMed, Embase, Web of science, clinical trial registry web sites (clinical trials,WHO clinical trial registry), Googlescholar, PubMed related articles and companies' web sites electronically up to Dec 30(th), 2012 and manually searched the reference lists and conference proceedings. Only randomized controlled trial (RCT) involving adult patients comparing idraparinux and/or idrabiotaparinux versus other anticoagulation methods for long-term VTE treatment was included. Two reviewers evaluated the studies and extracted data independently. Pooled risk ratios (RRs) were calculated as outcome measures and Revman 5.2 software was used to analyze data. Our primary efficacy and safety outcomes were the recurrent VTE and major bleeding rates.
  
  
  RESULTS
  We included four RCTs and involved 8584 participants on idraparinux or idrabiotaparinux versus standard warfarin for VTE treatment from 9364 references. We did not perform meta-analysis on the VTE rate because of the significant heterogeneity. We used the fixed effect model to analyze the safety outcomes and demonstrated that idraparinux or idrabiotaparinux decreased major bleeding rate significantly (RR 0.73, 95% CI 0.54 to 0.98, P = 0.04) but had a trend to increase the all cause mortality (RR 1.26, 95% CI 1.00 to 1.57, P = 0.05) compared with warfarin.
  
  
  CONCLUSIONS
  Until now there is not sufficient evidence to clarify whether idraparinux or idrabiotaparinux is as effective and safe as the standard warfarin treatment for VTE treatment.
authors.affiliation: Department of Hematology, BenQ Medical Center, Nanjing Medical University, Nanjing, Jiangsu Province, China.
authors.forename: Yanzhi
authors.initials: Y
authors.lastname: Song
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Li
authors.forename: Settipalli
authors.initials: S
authors.lastname: Pavithra
authors.forename: Dong
authors.initials: D
authors.lastname: Li
mesh_terms: D001710:Biotin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D009844:Oligosaccharides / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D054556:Venous Thromboembolism / Q000188:drug therapy*
chemical_list: D009844:Oligosaccharides; C479958:idraparinux; D001710:Biotin; C545956:idrabiotaparinux