Fondaparinux versus enoxaparin for the prevention of venous thromboembolism

Expert Opinion on Pharmacotherapy
Sheila A Doggrell

Abstract

Venous thromboembolism is a frequent, life-threatening, postoperative complication of hip-fracture and total-knee-replacement surgery. Fondaparinux is a synthetic polysaccharide that selectively binds to antithrombin, the primary endogenous regulator of blood coagulation. Low molecular weight heparins, such as enoxaparin, are less specific inhibitors of coagulation. In patients undergoing hip-fracture surgery, fondaparinux is more effective than once-daily enoxaparin as prophylaxis for venous thromboembolism. Fondaparinux (25 mg/day sc.) was also more effective than enoxaparin (30 mg sc. b.i.d.) as prophylaxis for venous thromboembolism in elective knee surgery. These differences may be explained by the fact that there is less prophylaxis cover with enoxaparin, as it has a much shorter duration of action than fondaparinux. Thus, with the present dosing regimens, fondaparinux is probably preferable to enoxaparin for the prevention of venous thromboembolism.

References

Mar 3, 2001·The New England Journal of Medicine·A G TurpieUNKNOWN Pentasaccharide Investigators
Jan 17, 2002·The New England Journal of Medicine·B I ErikssonUNKNOWN Steering Committee of the Pentasaccharide in Hip-Fracture Surgery Study
Jan 17, 2002·The New England Journal of Medicine·K A BauerUNKNOWN Steering Committee of the Pentasaccharide in Major Knee Surgery Study
Feb 28, 2002·Expert Opinion on Investigational Drugs·Jeanine M WalengaJawed Fareed

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Citations

Feb 27, 2007·São Paulo Medical Journal = Revista Paulista De Medicina·Winston Bonetti YoshidaFrancisco Humberto de Abreu Maffei
Jan 21, 2009·The Journal of Urology·John B ForrestUNKNOWN American Urological Association

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