Once-daily versus twice-daily enoxaparin for the initial treatment of acute deep venous thrombosis: a case–control study

BackgroundIn the initial treatment of deep venous thrombosis (DVT), enoxaparin is administered twice daily. A once-daily treatment regimen is more convenient for the patients and may optimize home treatment. However, it is not clear whether a once-daily treatment regimen is as safe and effective as a twice-daily treatment regimen.PurposeOur objective is to assess and compare the efficacy (in terms of recurrent venous thromboembolism) and safety (i.e. major hemorrhagic events) of once-daily versus twice-daily administration of enoxaparin for the initial treatment of DVT.Patients and methodsA case–control study was conducted. We studied the efficacy and safety of an enoxaparin regimen, 1.5 mg/kg once daily, as a bridge to warfarin for the treatment of acute DVT. We undertook a case–control design. We enrolled 40 acute DVT cases prospectively and matched them by age, sex, and location of venous thromboembolism to 40 previously treated controls. Only hospitalized patients were enrolled; no outpatients were studied. All controls had received enoxaparin 1 mg/kg twice daily. We followed the cases for 30 days. We discontinued enoxaparin after we achieved the target international normalized ratio between 2.0 and 3.0.ResultsOne (2.5%) case and two (5%) controls had recurrent venous thromboembolic events. There were no major bleeding complications in the case group, compared with one (2.5%) in the control group.ConclusionOnce-daily enoxaparin, 1.5 mg/kg, as a bridge to warfarin is as effective with a similar safety profile as twice-daily enoxaparin, 1 mg/kg, for initial treatment of acute DVT. Results showed no statistically significant differences between the two treatment regimens.