What question did this study set out to answer?

To evaluate whether age-related renal function decline or acute venous thromboembolism influences the pharmacodynamics of anti-factor Xa and anti-thrombin activities of nadroparin.

January 1, 1998Thrombosis and Haemostasis

Aging and Venous Thromboembolism Influence the Pharmacodynamics of the Anti-Factor Xa and Anti-thrombin Activities of a Low Molecular Weight Heparin (Nadroparin)

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Why the study?

Does aging and venous thromboembolism influence the pharmacodynamics of nadroparin in healthy subjects and patients with deep vein thrombosis?

Population

36 subjects divided into 3 groups of 12: healthy young volunteers (age 25 +/- 4 yrs, creatinine clearance…

Comparison

Nadroparin administered subcutaneously once… vs Comparison between the three groups.

Design

Cohort

Follow-up

6 to 10 days

Authors

PMPatrick MismettiGeneral / Preventive / Lipids SLS Laporte‐SimitsidisHôpital Pasteur CNChristelle NavarroMP Technologies (United States)

Discussion

Member takes

Implication

Supports caution with repeated nadroparin dosing in elderly or DVT patients; leaves open need for randomized dosing trials.

Key Points

To evaluate whether age-related renal function decline or acute venous thromboembolism influences the pharmacodynamics of anti-factor Xa and anti-thrombin activities of nadroparin.
Assessed three groups (n=12 each): healthy young volunteers (25 ± 4 years), healthy elderly volunteers (65 ± 3 years), and patients hospitalized for deep vein thrombosis (65 ± 11 years).
Administered subcutaneous nadroparin once daily at 180 anti-factor Xa IU/kg for 6 to 10 days, with serial blood sampling performed on day 1 and the final treatment day.
Repeated dosing caused significant anti-factor Xa accumulation in healthy elderly subjects and thrombosis patients (accumulation factor: 1.3) but not in young volunteers, while anti-thrombin activity showed no accumulation.
Creatinine clearance correlated significantly with anti-factor Xa clearance but showed no correlation with anti-thrombin clearance.
Patients with thrombosis demonstrated 1.4-fold higher anti-factor Xa clearance and 2.0-fold higher anti-thrombin clearance than healthy elderly controls, resulting in clearance ratios of 5.4 versus approximately 2 in healthy groups.

Structured PICO

Does aging and venous thromboembolism influence the pharmacodynamics of nadroparin in healthy subjects and patients with deep vein thrombosis?

Population

36 subjects divided into 3 groups of 12: healthy young volunteers (age 25 +/- 4 yrs, creatinine clearance 114 +/- 15 ml x min(-1)), healthy elderly volunteers (age 65 +/- 3 yrs, creatinine clearance 62 +/- 6 ml x min(-1)), and patients hospitalized for deep vein thrombosis (mean age 65 +/- 11 yrs, creatinine clearance 76 +/- 8 ml x min(-1)).

Intervention

Nadroparin administered subcutaneously once daily at the dose of 180 anti-factor Xa IU.kg(-1) for 6 to 10 days.

Comparator

Comparison between the three groups (healthy young, healthy elderly, and deep vein thrombosis patients).

Outcome

Pharmacodynamic parameters of the anti-factor Xa and anti-thrombin activities compared at the beginning (day 1) and at the end of the treatment (day n).surrogate

Aging and the presence of acute venous thromboembolism alter the pharmacodynamics of nadroparin, leading to accumulation of anti-factor Xa activity in elderly and DVT patients.

Cite This Study

Mismetti et al. (1998) studied this question.

synapsesocial.com/papers/6a6fecfbfebe604dd708bf42 https://doi.org/10.1055/s-0037-1615034

Topics

Anticoagulation in AF

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Aging and Venous Thromboembolism Influence the Pharmacodynamics of the Anti-Factor Xa and Anti-thrombin Activities of a Low Molecular Weight Heparin (Nadroparin)

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Aging and Venous Thromboembolism Influence the Pharmacodynamics of the Anti-Factor Xa and Anti-thrombin Activities of a Low Molecular Weight Heparin (Nadroparin)

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider