Questioning the Treatment of Venous Thromboembolism

Letters16 July 2002Questioning the Treatment of Venous ThromboembolismDavid K. CundiffDavid K. CundiffKailua-Kona, HI 96740 (Cundiff)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-2-200207160-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their review of clinical trials that have influenced the treatment of venous thromboembolism (1), Drs. Hirsh and Bates omitted a crucial study by Nielsen and colleagues (2). The Nielsen study compared anticoagulation with heparin plus phenprocoumon and therapy with phenylbutazone in patients with deep venous thrombosis (DVT). The results of the study were negative: One of 48 patients who received anticoagulants and 0 of 42 patients who received phenylbutazone died of pulmonary embolism. The only other previously published randomized, controlled trials of anticoagulants versus placebo in DVT also showed no benefit with anticoagulation (3, 4).Heparin ...References1. Hirsh J, Bates SM. Clinical trials that have influenced the treatment of venous thromboembolism: a historical perspective. Ann Intern Med. 2001;134:409-17. [PMID: 11242501] LinkGoogle Scholar2. Nielsen HK, Husted SE, Krusell LR, Fasting H, Charles P, Hansen HH, et al . Anticoagulant therapy in deep venous thrombosis. A randomized, controlled study. Thromb Res. 1994;73:215-26. [PMID: 8191414] CrossrefMedlineGoogle Scholar3. Kakkar VV, Flanc C, O'Shea M, Flute P, Howe CT, Clark MB. Treatment of deep-vein thrombosis—a random trial. Br J Surg. 1968;55:858. [PMID: 4879792] MedlineGoogle Scholar4. Ott P, Eldrup E, Oxholm P. [Value of anticoagulant therapy in deep venous thrombosis in the lower limb in elderly, mobilized patients. A double-blind placebo controlled study with open therapeutic guidance. Ugeskr Laeger. 1988;150:218-21. [PMID: 3287734] MedlineGoogle Scholar5. Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism. A controlled trial. Lancet. 1960;1:1309-12. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Kailua-Kona, HI 96740 (Cundiff) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoClinical Trials That Have Influenced the Treatment of Venous Thromboembolism: A Historical Perspective Jack Hirsh and Shannon M. Bates Questioning the Treatment of Venous Thromboembolism Jack Hirsh and Shannon Bates Metrics 16 July 2002Volume 137, Issue 2Page: 144-145KeywordsAnticoagulantsDeep vein thrombosisFood and Drug AdministrationHeparinLow molecular weight heparinLungsPulmonary embolismRandomized trialsVenous thromboembolismVitamin K ePublished: 16 July 2002 Issue Published: 16 July 2002 CopyrightCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...