Monotherapy with enoxaparin for the prevention of recurrent venous thromboembolism.

Abstract

This study aimed to determine whether a weight-adjusted dose of subcutaneous enoxaparin is as effective and safe as oral acenocoumarol for the secondary prophylaxis of pulmonary embolism. Three hundred and eighty consecutive noncancer outpatients hospitalized with an episode of symptomatic pulmonary embolism selected treatment with acenocoumarol or enoxaparin at a dose of 1 mg/kg once daily after being informed of the type of administration and expected frequency of laboratory monitoring for both medicinal products. Endpoints were symptomatic recurrent thromboembolic events evaluated by standard objective testing, and a composite endpoint of recurrent venous thromboembolism, major bleeding, and death from any cause. One hundred and ninety-nine patients (52%) chose acenocoumarol therapy and 181 chose enoxaparin monotherapy. Four patients in the enoxaparin group (2.2%) and six patients in the acenocoumarol group (3%) had an objective thromboembolic recurrence (hazard ratio, 1.35; 95% confidence interval, 0.38-4.79; P = 0.64). Nine patients in the enoxaparin group (5.0%) had a hemorrhagic complication compared with 11 in the acenocoumarol group (5.5%) (P = 0.81). The hospital length of stay was shorter with enoxaparin compared with acenocoumarol (11 versus 16 days, P = 0.0001). Enoxaparin is as effective and safe as acenocoumarol in the secondary prevention of recurrent thromboembolic disease and is associated with shorter hospitalization.

• Authors: David Jiménez Castro, Gema Díaz, David Martí, Carlos Escobar, Javier Ortega, Sergio García-Rull, Joaquin Picher, Antonio Sueiro
• Journal: Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis (Blood Coagul Fibrinolysis) Vol. 18 Issue 2 Pg. 173-7 (Mar 2007) ISSN: 0957-5235 [Print] England
• PMID: 17287635 (Publication Type: Comparative Study, Controlled Clinical Trial, Journal Article)

Chemical References

• Enoxaparin
• Acenocoumarol

Topics

• Acenocoumarol (administration & dosage, toxicity)
• Aged
• Aged, 80 and over
• Enoxaparin (administration & dosage, toxicity)
• Female
• Hemorrhage (chemically induced)
• Humans
• In Vitro Techniques
• Length of Stay
• Middle Aged
• Pulmonary Embolism (drug therapy)
• Secondary Prevention
• Venous Thrombosis (drug therapy)