Safety of desirudin in thrombosis prevention after total knee arthroplasty: the DESIR-ABLE study.

Abstract

Desirudin, administered 30 minutes before total hip arthroplasty is superior to enoxaparin in preventing proximal deep vein thrombosis (DVT) and pulmonary embolism (PE) with similar bleeding. The purpose of this study was to determine the safety of desirudin in patients undergoing elective total knee arthroplasty (TKA) when the first dose of desirudin was administered the evening after surgery. This is a case series of patients undergoing TKA who received desirudin 15 mg every 12 hours subcutaneously for an average of 5 days with the first dose administered postoperatively. The primary endpoint was major bleeding; secondary endpoints included wound outcomes (oozing and infection) and new symptomatic DVT or PE. Desirudin has a favorable safety profile when administered postoperatively in patients undergoing TKA with no reports of major bleeding, wound ooze, or infection. No patients experienced symptomatic DVT, but 2 patients had PE detected by computed tomography after experiencing atypical symptoms. The safety profile of desirudin is improved when administered postoperatively. Bleeding and wound outcomes seem to occur less frequently than historical desirudin and enoxaparin controls.

• Authors: Maurice Jove, Marc Maslanka, Harold S Minkowitz, Amir K Jaffer, DESIR-ABLE Investigators
• Journal: American journal of therapeutics (Am J Ther) 2014 Nov-Dec Vol. 21 Issue 6 Pg. 496-9 ISSN: 1536-3686 [Electronic] United States
• PMID: 23344102 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Anticoagulants
• Hirudins
• Recombinant Proteins
• desirudin

Topics

• Adult
• Aged
• Aged, 80 and over
• Anticoagulants (adverse effects, therapeutic use)
• Arthroplasty, Replacement, Knee (methods)
• Drug Administration Schedule
• Female
• Hemorrhage (chemically induced, epidemiology)
• Hirudins (administration & dosage, adverse effects)
• Humans
• Male
• Middle Aged
• Postoperative Period
• Pulmonary Embolism (prevention & control)
• Recombinant Proteins (administration & dosage, adverse effects, therapeutic use)
• Time Factors
• Venous Thrombosis (prevention & control)