Agents to Control Bleeding Show Promise

Abstract

Every year, thousands of patients develop deep vein thrombosis (DVT) and are at risk of pulmonary embolism after undergoing surgeries, particularly orthopedic procedures in the hips and legs. Although low-molecular-weight heparin is considered the standard therapy for DVT and other forms of venous thromboembolism, it is far from an ideal anticoagulant. Its drawbacks include the need for daily injections, adverse interactions with many types of drugs, and a wide variation in patient response. Researchers have therefore continued to search for alternative therapies. A phase 2 randomized, open-label trial funded by Sanofi-Aventis assessed the potential of idraparinux for preventing DVT and pulmonary embolism. This anticoagulant, which targets a molecule in the coagulation cascade, can be taken less often than low-molecular-weight heparin. In the study,2904patientswithaprevious DVT episode were randomized to receive idraparinuxbysubcutaneous injectiononceaweekorstandardtreatment, including daily injections of lowmolecular-weightheparin.After3months of therapy, idraparinux proved to be as effectiveas thestandardtreatment inpreventing venous clot recurrence (2.9% vs 3.0% recurrence respectively). Severe bleeding, apotential adverseeffectof anticoagulants,occurredin4.5%ofpatients taking idraparinux and in 7.0% of those receiving standard therapy.