On 2014 Dec 31, Andrea Messori commented:

Prevention of venous thromboembolism in major orthopaedic surgery

For nearly two decades, low-molecular weight heparins (LMWHs) have been considered the standard of care for preventing venous thromboembolism (VTE) in patients at risk. In this field, two meta-analyses have summarized the results of all RCTs published in Medline [1,2].

The systematic review by Sobieraj et al.,[1] reported the incidence rates for deep vein thrombosis and for pulmonary embolism which were compared between enoxaparin and other heparins (e.g., unfractionated heparin or LMWH); this review evaluated a total of 13 RCTs.

The meta-analysis by Maratea et al.,[2] reported the incidence rates for the composite end-point of deep vein thrombosis and pulmonary embolism which were compared between enoxaparin and NOACs (novel oral anticoagulants). This meta-analysis evaluated a total of 8 RCTs. Table 1 available at the following website http://www.osservatorioinnovazione.net/papers/heparins_trials_2014.pdf summarizes the raw data for the incidence of the composite end-point obtained from the overall series of trials mentioned above. To compare the various treatments with one another, the class of LMWHs was divided according to the specific agents employed in the trials. Furthermore, enoxaparin was considered as two separate treatments depending on whether this agent was given once daily or twice daily. Our synthesis of effectiveness data can be useful for retrospective evaluations in this therapeutic area and also as a reference for defining the place in therapy of innovative treatments developed for this clinical indication.

References

1.Sobieraj DM, Coleman CI, Tongbram V, Lee S, Colby J, Chen WT, Makanji SS, Ashaye A, Kluger J, White CM. Venous Thromboembolism Prophylaxis in Orthopedic Surgery [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 (b) Mar. Available from http://www.ncbi.nlm.nih.gov/books/NBK92319/ PubMed PMID: 22536611.

2.Maratea D, Fadda V, Trippoli S, Messori A. Prevention of venous thromboembolism after major orthopedic surgery: indirect comparison of three new oral anticoagulants. J Thromb Haemost. 2011 Sep;9(9):1868-70. doi: 10.1111/j.1538-7836.2011.04421.x.

On 2014 Dec 31, Andrea Messori commented:

Prevention of venous thromboembolism in major orthopaedic surgery

For nearly two decades, low-molecular weight heparins (LMWHs) have been considered the standard of care for preventing venous thromboembolism (VTE) in patients at risk. In this field, two meta-analyses have summarized the results of all RCTs published in Medline [1,2].

The systematic review by Sobieraj et al.,[1] reported the incidence rates for deep vein thrombosis and for pulmonary embolism which were compared between enoxaparin and other heparins (e.g., unfractionated heparin or LMWH); this review evaluated a total of 13 RCTs.

The meta-analysis by Maratea et al.,[2] reported the incidence rates for the composite end-point of deep vein thrombosis and pulmonary embolism which were compared between enoxaparin and NOACs (novel oral anticoagulants). This meta-analysis evaluated a total of 8 RCTs. Table 1 available at the following website http://www.osservatorioinnovazione.net/papers/heparins_trials_2014.pdf summarizes the raw data for the incidence of the composite end-point obtained from the overall series of trials mentioned above. To compare the various treatments with one another, the class of LMWHs was divided according to the specific agents employed in the trials. Furthermore, enoxaparin was considered as two separate treatments depending on whether this agent was given once daily or twice daily. Our synthesis of effectiveness data can be useful for retrospective evaluations in this therapeutic area and also as a reference for defining the place in therapy of innovative treatments developed for this clinical indication.

References

1.Sobieraj DM, Coleman CI, Tongbram V, Lee S, Colby J, Chen WT, Makanji SS, Ashaye A, Kluger J, White CM. Venous Thromboembolism Prophylaxis in Orthopedic Surgery [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 (b) Mar. Available from http://www.ncbi.nlm.nih.gov/books/NBK92319/ PubMed PMID: 22536611.

2.Maratea D, Fadda V, Trippoli S, Messori A. Prevention of venous thromboembolism after major orthopedic surgery: indirect comparison of three new oral anticoagulants. J Thromb Haemost. 2011 Sep;9(9):1868-70. doi: 10.1111/j.1538-7836.2011.04421.x.