Lancet 05/16/2002 By Harvey McConnell
A new class of synthetic antithrombotic agents could be more effective than conventional therapy in reducing the risk of potentially fatal blood clots developing following hip-replacements.
Two studies by the same team of investigators – one done in Europe, the second in North America – assessed the ability of the pentasaccharide fondaparinux to further reduce the risk of venous thromboembolic complications.
The frequency of risk of deep-vein thrombosis (DVT) in hip replacements ranges from 16 to 30 percent, despite the use of anticoagulant prophylactic treatments such as low-dose heparin, low molecular-weight heparin, warfarin or recombinant hirudin. In the European study, researchers led by Dr. Michael Rud Lassen of University Hospital Copenhagen in Denmark randomly assigned 2,309 consecutive patients, 18 years or over, from 16 countries to one of two treatments.
Patients received either daily injections of either 2.5 milligrams of fondaparinux postoperatively or 40 mg of the anti-clotting agent enoxaparin starting preoperatively. Primary efficacy outcome data were available for 1,827 patients (79 percent).
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