Key result
New antithrombotic agents have been evaluated against placebo or unfractionated heparin for DVT, but their advantages over gold-standard low molecular weight heparins remain unclear.
Why the study?
Do new antithrombotic agents improve efficacy and safety compared to placebo or unfractionated heparin in the prevention and treatment of DVT?
Do new antithrombotic agents improve efficacy and safety compared to placebo or unfractionated heparin in the prevention and treatment of DVT?
The clinical utility of new antithrombotic agents for DVT remains unclear due to the lack of head-to-head comparisons with the gold standard, low molecular weight heparin.
New antithrombotics should not replace LMWH for DVT without direct comparisons; leaves open their relative efficacy and safety.
Besides low molecular weight heparins (LMWHs) a number of new antithrombotic agents have been evaluated mainly in the prevention of deep vein thrombosis (DVT) and, to a lesser extent, in the treatment of established DVT. They include the Pentasaccharide, a synthetic ultra LMWH, Dermatan Sulphate, a glycosaminoglycan which activates heparin cofactor II, Orgaran, a mixture of Heparan and of Dermatan Sulphate, Hirulog and Hirudin, two direct thrombin inhibitors. The efficacy and safety of these compounds have been studied in comparison with a placebo or with unfractionated heparin but not with LMWH which is considered as a gold standard for these clinical indications. It is thus difficult at present to appreciate the advantages of these new antithrombotic agents over conventional LMWH therapy.
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B Boneu (2009) conducted a review in Deep vein thrombosis. New antithrombotic agents (Pentasaccharide, Dermatan Sulphate, Orgaran, Hirulog, Hirudin) vs. Placebo or unfractionated heparin was evaluated on Prevention and treatment of deep vein thrombosis. New antithrombotic agents have been evaluated against placebo or unfractionated heparin for DVT, but their advantages over gold-standard low molecular weight heparins remain unclear.
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