Efficacy and safety of once weekly subcutaneous idrabiotaparinux in the treatment of patients with symptomatic deep venous thrombosis.

Abstract

BACKGROUND:

Idraparinux, a long acting inhibitor of factor (F) Xa, is as effective as standard anticoagulant therapy for patients with symptomatic deep venous thrombosis. We investigated the potential use of the biotinylated molecule, idrabiotaparinux. Biotinylation enables reversal of the anticoagulant effect.

METHODS:

We performed a randomized double-blind trial in 757 patients with symptomatic deep venous thrombosis, comparing equimolar doses of idrabiotaparinux (3 mg) with idraparinux (2.5 mg), both given subcutaneously, once weekly for 6 months. Inhibition of FXa activity was measured at days 15, 36, 57, 92 and 183. The efficacy outcome was recurrent venous thromboembolism. The safety outcomes were clinically relevant bleeding and death.

RESULTS:

Inhibition of FXa was similar in the two treatment groups at each time point of measurement. Recurrent venous thromboembolism during the 6-month treatment period occurred in nine of 386 patients (2.3%) in the idrabiotaparinux group and in 12 of 371 patients (3.2%) in the idraparinux group, a difference of - 0.9% (95% confidence interval, -3.2-1.4%). The incidence of clinically relevant bleeding was 5.2% in the idrabiotaparinux group and 7.3% in the idraparinux group (P = 0.29), a difference of - 2.1% (95% confidence interval, -5.6-1.4%). Six patients (1.6%) who received idrabiotaparinux died, compared with 12 patients (3.2%) given idraparinux, a difference of - 1.7% (95% confidence interval, -3.9-0.5%).

CONCLUSIONS:

Idrabiotaparinux has a similar time course of FXa inhibition, efficacy and safety to idraparinux for the treatment of deep venous thrombosis.

• Authors: Equinox Investigators
• Journal: Journal of thrombosis and haemostasis : JTH (J Thromb Haemost) Vol. 9 Issue 1 Pg. 92-9 (Jan 2011) ISSN: 1538-7836 [Electronic] England
• PMID: 20946157 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2010 International Society on Thrombosis and Haemostasis.

Chemical References

• Anticoagulants
• Factor Xa Inhibitors
• Oligosaccharides
• idraparinux
• Biotin
• idrabiotaparinux

Topics

• Adult
• Aged
• Anticoagulants (administration & dosage, adverse effects)
• Biotin (administration & dosage, adverse effects, analogs & derivatives)
• Blood Coagulation (drug effects)
• Double-Blind Method
• Drug Administration Schedule
• Europe
• Factor Xa Inhibitors
• Female
• Hemorrhage (chemically induced)
• Humans
• Injections, Subcutaneous
• Male
• Middle Aged
• Oligosaccharides (administration & dosage, adverse effects)
• Recurrence
• Risk Assessment
• Time Factors
• Treatment Outcome
• United States
• Venous Thrombosis (blood, drug therapy, mortality)