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George Wells - One of the best experts on this subject based on the ideXlab platform.
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ORIGINAL INVESTIGATION A Randomized Trial Comparing 2 Low-Molecular-
2015Co-Authors: Weight Heparins, George Wells, Outpatient Treatment, Phd Judy Kovacs, Rn Michael, J. KovacsAbstract:(LMWHs) are now standard therapy for the treatment of deep vein thrombosis (DVT) and pulmonary embo-lism (PE). No published trials have compared LMWHs, and few studies have examined outpatient therapy for PE. Only Tinzaparin Sodium has demonstrated superiority to unfractionated heparin in a clinical trial. Methods: We compared 2 LMWH products, tinzapa-rin and dalteparin Sodium, for the treatment of acute DVT and PE in a randomized, controlled clinical trial of con-secutive outpatients presenting to a venous thromboem-bolism service at 4 tertiary-care hospitals. Patients were treated with subcutaneous Tinzaparin Sodium, 175 IU/kg every 24 hours, or subcutaneous dalteparin Sodium, 200 IU/kg every 24 hours, for at least 5 days. Warfarin so-dium therapy was started simultaneously and contin-ued for 90 days. The primary end point was efficacy (re-currence of venous thromboembolism); safety (bleeding) was a composite end point. Results: Two hundred fifty-four patients received tin-zaparin (39 with PE and 215 with DVT) and 251 re-ceived dalteparin (51 with PE and 200 with DVT). Most patients had an active malignancy or idiopathic DVT/ PE. The outcome events occurred in 11 (4.4%; 95 % con-fidence interval [CI],2.2%-7.7%) and 15 patients (5.9%; 95 % CI,3.3%-9.5%) in the dalteparin and Tinzaparin groups, respectively, including 9 and 10 recurrences, re-spectively, and 2 and 5 major hemorrhages, respectively (P=.44). The 95 % CI on the difference of −1.5 % was −5.3% to 2.4%. Conclusions: Tinzaparin and dalteparin are safe and ef-fective for the outpatient treatment of DVT or PE. Our finding of no differences between the LMWHs based on major clinical end points means that practical issues can be the deciding factor on which drug to use. Arch Intern Med. 2005;165:733-73
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A Randomized Trial Comparing 2 Low-Molecular- Weight Heparins for the Outpatient Treatment of Deep Vein Thrombosis and Pulmonary Embolism
JAMA Internal Medicine, 2005Co-Authors: Philip S Wells, Peggy Florack, Beverly Morrow, Melissa Forgie, Marc Rodger, Lisa Gray, Donna Touchie, Keith O'rourke, David R. Anderson, George WellsAbstract:Background: Low-molecular-weight heparins (LMWHs) are now standard therapy for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE). No published trials have compared LMWHs, and few studies have examined outpatient therapy for PE. Only Tinzaparin Sodium has demonstrated superiority to unfractionated heparin in a clinical trial. Methods: We compared 2 LMWH products, Tinzaparin and dalteparin Sodium, for the treatment of acute DVT and PE in a randomized, controlled clinical trial of consecutive outpatients presenting to a venous thromboembolism service at 4 tertiary-care hospitals. Patients were treated with subcutaneous Tinzaparin Sodium, 175 IU/kg every 24 hours, or subcutaneous dalteparin Sodium, 200 IU/kg every 24 hours, for at least 5 days. Warfarin Sodium therapy was started simultaneously and continued for 90 days. The primary end point was efficacy (recurrence of venous thromboembolism); safety (bleeding) was a composite end point. Results: Two hundred fifty-four patients received Tinzaparin (39 with PE and 215 with DVT) and 251 received dalteparin (51 with PE and 200 with DVT). Most patients had an active malignancy or idiopathic DVT/ PE. The outcome events occurred in 11 (4.4%; 95% confidence interval [CI],2.2%-7.7%) and 15 patients (5.9%; 95% CI, 3.3%-9.5%) in the dalteparin and Tinzaparin groups, respectively, including 9 and 10 recurrences, respectively, and 2 and 5 major hemorrhages, respectively (P=.44). The 95% CI on the difference of �1.5% was �5.3% to 2.4%. Conclusions: Tinzaparin and dalteparin are safe and effective for the outpatient treatment of DVT or PE. Our finding of no differences between the LMWHs based on major clinical end points means that practical issues can be the deciding factor on which drug to use.
Philip S Wells - One of the best experts on this subject based on the ideXlab platform.
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A Randomized Trial Comparing 2 Low-Molecular- Weight Heparins for the Outpatient Treatment of Deep Vein Thrombosis and Pulmonary Embolism
JAMA Internal Medicine, 2005Co-Authors: Philip S Wells, Peggy Florack, Beverly Morrow, Melissa Forgie, Marc Rodger, Lisa Gray, Donna Touchie, Keith O'rourke, David R. Anderson, George WellsAbstract:Background: Low-molecular-weight heparins (LMWHs) are now standard therapy for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE). No published trials have compared LMWHs, and few studies have examined outpatient therapy for PE. Only Tinzaparin Sodium has demonstrated superiority to unfractionated heparin in a clinical trial. Methods: We compared 2 LMWH products, Tinzaparin and dalteparin Sodium, for the treatment of acute DVT and PE in a randomized, controlled clinical trial of consecutive outpatients presenting to a venous thromboembolism service at 4 tertiary-care hospitals. Patients were treated with subcutaneous Tinzaparin Sodium, 175 IU/kg every 24 hours, or subcutaneous dalteparin Sodium, 200 IU/kg every 24 hours, for at least 5 days. Warfarin Sodium therapy was started simultaneously and continued for 90 days. The primary end point was efficacy (recurrence of venous thromboembolism); safety (bleeding) was a composite end point. Results: Two hundred fifty-four patients received Tinzaparin (39 with PE and 215 with DVT) and 251 received dalteparin (51 with PE and 200 with DVT). Most patients had an active malignancy or idiopathic DVT/ PE. The outcome events occurred in 11 (4.4%; 95% confidence interval [CI],2.2%-7.7%) and 15 patients (5.9%; 95% CI, 3.3%-9.5%) in the dalteparin and Tinzaparin groups, respectively, including 9 and 10 recurrences, respectively, and 2 and 5 major hemorrhages, respectively (P=.44). The 95% CI on the difference of �1.5% was �5.3% to 2.4%. Conclusions: Tinzaparin and dalteparin are safe and effective for the outpatient treatment of DVT or PE. Our finding of no differences between the LMWHs based on major clinical end points means that practical issues can be the deciding factor on which drug to use.
Hans Flodgaard - One of the best experts on this subject based on the ideXlab platform.
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Binding of low molecular weight heparin (Tinzaparin Sodium) to bovine endothelial cells in vitro
Thrombosis research, 1994Co-Authors: Anni Larnkjær, Per Østergaard, Hans FlodgaardAbstract:Abstract Heparinase depolymerized low molecular weight (LMW) heparin (Tinzaparin Sodium, Logiparin®) was radiolabelled by catalytic tritiation to high specific radioactivity and the binding to fetal bovine heart endothelial (FBHE) cells was studied at 4°C and 37°C. The binding was found to be time dependent and saturable. Two classes of binding sites could be distinguished from Scatchard analysis at both temperatures: One with high affinity (K D = 0.027 μM at 4°C, K D = 0.012 μM at 37°C) and another with very low affinity (K D = 69 μM at 4°C and 37 μM at 37°C). The binding reversibility was affected by the temperature indicating internalization of a fraction of the bound LMW heparin. At 4°C only 11% of the specifically bound heparin was bound irreversibly. At 37°C the non displaceable fraction accounted for 28 % of the specifically bound LMW heparin. This work demonstrates that Tinzaparin Sodium binds specifically to endothelial cells. This binding may be useful in interpreting pharmacokinetic properties of this low molecular weight heparin.
Peggy Florack - One of the best experts on this subject based on the ideXlab platform.
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A Randomized Trial Comparing 2 Low-Molecular- Weight Heparins for the Outpatient Treatment of Deep Vein Thrombosis and Pulmonary Embolism
JAMA Internal Medicine, 2005Co-Authors: Philip S Wells, Peggy Florack, Beverly Morrow, Melissa Forgie, Marc Rodger, Lisa Gray, Donna Touchie, Keith O'rourke, David R. Anderson, George WellsAbstract:Background: Low-molecular-weight heparins (LMWHs) are now standard therapy for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE). No published trials have compared LMWHs, and few studies have examined outpatient therapy for PE. Only Tinzaparin Sodium has demonstrated superiority to unfractionated heparin in a clinical trial. Methods: We compared 2 LMWH products, Tinzaparin and dalteparin Sodium, for the treatment of acute DVT and PE in a randomized, controlled clinical trial of consecutive outpatients presenting to a venous thromboembolism service at 4 tertiary-care hospitals. Patients were treated with subcutaneous Tinzaparin Sodium, 175 IU/kg every 24 hours, or subcutaneous dalteparin Sodium, 200 IU/kg every 24 hours, for at least 5 days. Warfarin Sodium therapy was started simultaneously and continued for 90 days. The primary end point was efficacy (recurrence of venous thromboembolism); safety (bleeding) was a composite end point. Results: Two hundred fifty-four patients received Tinzaparin (39 with PE and 215 with DVT) and 251 received dalteparin (51 with PE and 200 with DVT). Most patients had an active malignancy or idiopathic DVT/ PE. The outcome events occurred in 11 (4.4%; 95% confidence interval [CI],2.2%-7.7%) and 15 patients (5.9%; 95% CI, 3.3%-9.5%) in the dalteparin and Tinzaparin groups, respectively, including 9 and 10 recurrences, respectively, and 2 and 5 major hemorrhages, respectively (P=.44). The 95% CI on the difference of �1.5% was �5.3% to 2.4%. Conclusions: Tinzaparin and dalteparin are safe and effective for the outpatient treatment of DVT or PE. Our finding of no differences between the LMWHs based on major clinical end points means that practical issues can be the deciding factor on which drug to use.
Keith O'rourke - One of the best experts on this subject based on the ideXlab platform.
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A Randomized Trial Comparing 2 Low-Molecular- Weight Heparins for the Outpatient Treatment of Deep Vein Thrombosis and Pulmonary Embolism
JAMA Internal Medicine, 2005Co-Authors: Philip S Wells, Peggy Florack, Beverly Morrow, Melissa Forgie, Marc Rodger, Lisa Gray, Donna Touchie, Keith O'rourke, David R. Anderson, George WellsAbstract:Background: Low-molecular-weight heparins (LMWHs) are now standard therapy for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE). No published trials have compared LMWHs, and few studies have examined outpatient therapy for PE. Only Tinzaparin Sodium has demonstrated superiority to unfractionated heparin in a clinical trial. Methods: We compared 2 LMWH products, Tinzaparin and dalteparin Sodium, for the treatment of acute DVT and PE in a randomized, controlled clinical trial of consecutive outpatients presenting to a venous thromboembolism service at 4 tertiary-care hospitals. Patients were treated with subcutaneous Tinzaparin Sodium, 175 IU/kg every 24 hours, or subcutaneous dalteparin Sodium, 200 IU/kg every 24 hours, for at least 5 days. Warfarin Sodium therapy was started simultaneously and continued for 90 days. The primary end point was efficacy (recurrence of venous thromboembolism); safety (bleeding) was a composite end point. Results: Two hundred fifty-four patients received Tinzaparin (39 with PE and 215 with DVT) and 251 received dalteparin (51 with PE and 200 with DVT). Most patients had an active malignancy or idiopathic DVT/ PE. The outcome events occurred in 11 (4.4%; 95% confidence interval [CI],2.2%-7.7%) and 15 patients (5.9%; 95% CI, 3.3%-9.5%) in the dalteparin and Tinzaparin groups, respectively, including 9 and 10 recurrences, respectively, and 2 and 5 major hemorrhages, respectively (P=.44). The 95% CI on the difference of �1.5% was �5.3% to 2.4%. Conclusions: Tinzaparin and dalteparin are safe and effective for the outpatient treatment of DVT or PE. Our finding of no differences between the LMWHs based on major clinical end points means that practical issues can be the deciding factor on which drug to use.