Fondaparinux: use in thromboprophylaxis of acute medical patients

Drugs & Aging
Sohita Dhillon, Greg L Plosker

Abstract

Fondaparinux is a synthetic pentasaccharide that inhibits thrombin formation and thrombus development via selective antithrombin mediated inhibition of factor Xa. The complete bioavailability (100%) and elimination half-life of approximately 17 hours allows once-daily administration of fondaparinux. In a well designed trial (ARTEMIS) in acute medical patients aged > or = 60 years, fondaparinux was significantly more effective than placebo in terms of reducing the incidence of venous thromboembolism (VTE) up to day 15. The beneficial effect of fondaparinux therapy was observed in all subgroups of patients irrespective of underlying illness (e.g. acute heart failure or acute respiratory disease) in a predefined subgroup analysis of the ARTEMIS trial. Similarly, in a retrospective analysis of the trial, age and renal function did not appear to affect the incidence of VTE in fondaparinux and placebo recipients. Fondaparinux was generally well tolerated in this clinical trial. In patients receiving fondaparinux, the incidence of major bleeding was similar to that in patients receiving placebo and the incidence of minor bleeding was <3%.

References

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Citations

Sep 1, 2009·Clinical Drug Investigation·Parham Khosravi-Shahi, Gumersindo Pérez-Manga
Nov 27, 2010·Expert Review of Cardiovascular Therapy·Andrew L FreemanMatthew T Rondina

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