A study of the RIETE group shows that a daily injection is associated to less major bleedings and less mortality

 

Enoxaparin is the most used low molecular weight heparin for the prevention of a thrombotic episode, and the first line therapy of an anticoagulant treatment among patients who have developed a venous thrombosis and/or pulmonary embolism.

It is an injection that “inhibits coagulation by enhancing the inhibiting effect of antithrombin III over the factors IIa and Xa”, just as Vademecum describes. A drug with different prescription depending on the country and practical guidelines: for venous thromboembolic disease (VTE) treatment in some cases two daily doses (injections) are recommended, every 12 hours, while in other cases, only one is indicated.

Moreover, quantity of enoxaparin also varies. Protocols that recommend two doses indicate two injections of 1 mg each one, while literature prescribes one unique dose of 1,5 mg.

A study of the RIETE group, recently published in the Journal of Thrombosis and Haemostasis, has compared both administration ways of enoxaparin as VTE treatment and concludes that one unique injection is more beneficial and efficient for the patient.

The analysis has compared the evolution of 4.730 patients after two weeks and 30 days of treatment with enoxaparin. Most of them, 80% (3.786), had two daily injections, while the other 20% (944) had one daily injection.

When evaluating the results, experts have confirmed that patients who received a daily dose of low molecular weight heparin had less major bleedings and less mortality rate than those who had two daily injections (both at the end of 15 and 30 days). Recurrence of a new thrombotic episode was similar in both cases.

This study contradicts the belief that two daily doses of enoxaparin had a better stabilization of anticoagulation, and reduced complications. However, this is still a minority practice among the doctors who treat VTE all around the world. In Spain, for instance, only 1 out of 3 specialists prescribes one unique dose of enoxaparin.

 

 

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