NEW YORK (MedscapeWire) May 20
Fondaparinux given prophylactically after hip surgery results in fewer episodes of deep vein thrombosis (DVT) than does the low-molecular-weight heparin (LMWH) enoxaparin, according to the results of a double-blind study published in the May 18 issue of The Lancet. But the trade-off may be higher risk of bleeding, which may be a relative contraindication in patients with coagulation abnormalities.
Fondaparinux, a synthetic pentasaccharide antithrombotic agent that specifically inhibits factor Xa and has no activity against thrombin, is the first in this class.
“Drugs that act through specific inhibition of factor Xa, such as fondaparinux, could be more effective than LMWHs in prevention of venous thromboembolism in patients undergoing hip-replacement surgery,” write Michael Rud Lassen, from University Hospital Copenhagen in Denmark, and colleagues. In the European Pentasaccharide Hip Elective Surgery Study (EPHESUS), investigators randomized 2309 patients from 16 European countries who were undergoing elective hip-replacement surgery to once-daily injections of either 2.5 mg of fondaparinux, starting postoperatively, or 40 mg of enoxaparin, starting preoperatively.
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