Choosing Between Enoxaparin and Fondaparinux for the Prevention of Thromboembolism: A Meta-Analysis of Randomized Trials

Background: Venous thromboembolism (VTE), are few of the most serious complications in ICU. There are Pharmacological and mechanical prophylaxis methods are used to reduce the risk of thromboembolism and the most efficient is the pharmacological methods which is based on a fine balance between their efficacy and the adverse effects associated with them. Objectives: To evaluate, effectiveness, and clinical impact of VTE prophylaxis with fondaparinux and enoxaparin on patient outcomes in different clinical practices. Study design: Meta-analysis was used to address this concern. Sittings: Meta-analysis-based study following the PRISMA (Preferred Reporting Items for Systematic Reviews and MetaAnalyses) guidelines. Methods: Online databases (PubMed/Medline, EMBASE, and Cochrane library) were used for randomized studies which compared differences in clinical outcomes observed with the use of Fondaparinux and enoxaparin in patients who were treated for thromboembolism. Results: Thirteen studies were identified for inclusion in this study, involving a total of 64,350 patients. The risk of bias was low. Meta-analysis found that Fondaparinux result in significant reduction in incidence of bleeding than Enoxaparin (R.R. = 0.85 [0.81, 0.88]; 95% CI; I2 = 100%; P< .00001) also showed that that Fondaparinux result in significant decrease in venous thromboembolism than enoxaparin (R.R. = 0.52 [0.47, 0.58]; 95% CI; I2 = 62 + %; P < .00001). There was no significant difference in the incidence of mortality, pulmonary embolism, stroke, and incidence of transfusion between two groups among the studies included in the meta-analysis. Conclusion: Fondaparinux was associated with superior efficacy in reduction of incidence of bleeding and incidence of occurrence of venous thromboembolism.