Key result
Daily enoxaparin reduces VTE risk ~69% vs placebo in acutely ill ambulatory medical patients.
Why the study?
In the US, ambulatory status is often used as a criterion to stop VTE prophylaxis, but the impact of ambulation on VTE risk and thromboprophylaxis efficacy in acutely ill medical patients was unclear.
Does enoxaparin 40 mg once daily reduce venous thromboembolism risk compared to placebo in acutely ill medical patients regardless of their ambulatory status?
RCT (n=1,084)
Does enoxaparin 40 mg once daily reduce venous thromboembolism risk compared to placebo in acutely ill medical patients regardless of their ambulatory status?
Relative Risk: 0.31 (95% CI 0.13–0.78)
Absolute Event Rate: 3.3% vs 10.6%
p-value: p=0.008
Enoxaparin 40 mg once daily significantly reduces VTE risk in acutely ill medical patients even after they achieve ambulatory status, challenging the practice of stopping prophylaxis upon ambulation.
No takes yet. Share an insight, caveat, or question.
May support continued prophylaxis in ambulatory patients; extends prior data but remains hypothesis-generating pending randomized trials.
Girard et al. (2010) conducted an RCT in Acutely ill medical patients at risk for venous thromboembolism (n=1,084). Enoxaparin vs. Placebo was evaluated on Venous thromboembolism (VTE) in ambulatory patients (RR 0.31, 95% CI 0.13-0.78, p=0.008). Enoxaparin 40 mg once daily significantly reduced VTE risk versus placebo in acutely ill ambulatory medical patients (3.3% vs. 10.6%; RR 0.31; 95% CI 0.13-0.78; p=0.008).
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