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DANAPAROID FOR DVT.

Heparin, the standard treatment for deep venous thrombosis, carries a major risk for bleeding. This multicenter, randomized trial from the Netherlands compared heparin with danaparoid -- a mixture of low-molecular-weight heparan sulfate, dermatan sulfate, and chondroitin sulfate that has no effect on platelet function. Investigators enrolled 209 consecutive patients with suspected DVT; 188 had confirmed DVT and completed the trial, receiving either standard-dose adjusted intravenous heparin or subcutaneous danaparoid (1250 or 2000 units twice daily after an IV loading dose). After five to eight days, the patients given high-dose (but not low-dose) danaparoid had significantly less recurrence or extension of venous thromboembolism than the heparin group (13 vs. 28 percent) and less recurrent pulmonary embolism (7 vs. 24 percent). Major bleeds occurred in two patients given heparin versus one in each danaparoid group, although significantly more danaparoid-treated patients had risk factors for bleeding. Comment: These findings suggest that danaparoid may be a useful alternative to standard heparin for DVT. But they need confirmation in larger trials, some of which should compare danaparoid with low-molecular-weight heparins and evaluate costs. This trial received partial funding from the maker of danaparoid.

— CD Mulrow

Published in Journal Watch General Medicine July 7, 1995

Citation(s):

de Valk HW, et al. Comparing subcutaneous danaparoid with intravenous unfractionated heparin for the treatment of venous thromboembolism: a randomized controlled trial. Ann Intern Med 1995 Jul 1 123 1-9.

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