Subcutaneous nadroparin reduced the incidence of deep-vein thrombosis by 45% compared with placebo (15.5% vs 28.2%; p=0.045) in mechanically ventilated patients with acute decompensated COPD.
RCT (n=223)
randomized
Does subcutaneous nadroparin reduce the incidence of deep-vein thrombosis in mechanically ventilated patients with acute decompensated COPD?
In mechanically ventilated patients with acute decompensated COPD, weight-adjusted subcutaneous nadroparin significantly reduces the incidence of DVT by 45% compared to placebo without a significant increase in adverse events.
Absolute Event Rate: 15.5% vs 28.2%
p-value: p=0.045
Low molecular weight heparins are as effective as unfractionated heparin in deep-vein thrombosis (DVT) prophylaxis for major surgery. However, there is no evidence nor consensus for prophylaxis in medical patients. We compared the efficacy and safety of nadroparin calcium (nadroparin) with placebo in medical patients at high risk of DVT. A total of 223 patients mechanically ventilated for acute, decompensated chronic obstructive pulmonary disease, were randomized to treatment with subcutaneous nadroparin adjusted for body weight (0.4 ml, i.e., 3,800 AXa IU, or 0.6 ml, i.e., 5,700 AXa IU) or placebo. The average duration of treatment was 11 d. The incidence of DVT in patients receiving nadroparin was significantly lower than that in patients receiving placebo (15.5 versus 28.2%; p = 0.045). Although the incidence of adverse events was high in both groups, there were no significant differences between nadroparin and placebo for total adverse events (46.3 versus 39.8%; p = 0.33), serious adverse events (25.0 versus 19.5%; p = 0.32), or those resulting in early permanent discontinuation of treatment (12.0 versus 8.8%; p = 0.44). The most common adverse event was hemorrhage. There was the same number of deaths in both treatment groups. Subcutaneous nadroparin resulted in 45% decrease in incidence of DVT compared with placebo.
Fraisse et al. (Sat,) conducted a rct in Acute decompensated chronic obstructive pulmonary disease (n=223). Nadroparin calcium vs. Placebo was evaluated on Incidence of deep-vein thrombosis (DVT) (p=0.045). Subcutaneous nadroparin reduced the incidence of deep-vein thrombosis by 45% compared with placebo (15.5% vs 28.2%; p=0.045) in mechanically ventilated patients with acute decompensated COPD.