Dosing Strategy and Bleeding Risk in VTE: Is Less Frequent Injection Better?
Patients who took enoxaparin once daily had few major bleeds compared with patients who took enoxaparin twice daily.
HealthDay News – Once-daily enoxaparin is associated with fewer major bleeds than enoxaparin twice daily in patients with acute venous thromboembolism (VTE), according to a study published online in the Journal of Thrombosis and Haemostasis.
Javier Trujillo-Santos, MD, PhD, from the Hospital General Universitario Santa Lucía in Murcia, Spain, and colleagues assessed data from the RIETE (Registry of Patients with Venous Thromboembolism) registry for 4730 patients receiving enoxaparin: 3786 and 944 received enoxaparin twice and once daily, respectively.
The researchers found that, compared with those receiving enoxaparin twice daily, once-daily enoxaparin correlated with a trend toward more VTE recurrences (odds ratio [OR], 1.79; 95% CI, 0.55-5.88), fewer major bleeds (OR, 0.42; 95% CI, 0.17-1.08), and fewer deaths (OR, 0.32; 95% CI, 0.13-0.78) during the first 15 days. Patients on enoxaparin once daily had more VTE recurrences (OR, 2.5; 95% CI, 1.03-5.88), fewer major bleeds (OR, 0.40; 95% CI, 0.17-0.94), and fewer deaths (OR, 0.58; 95% CI, 0.33-1.00) at day 30.
On propensity analysis, patients on enoxaparin once daily had fewer bleeds at 15 and 30 days (hazard ratio [HR], 0.30; 95% CI, 0.10-0.88 and HR, 0.16; 95% CI, 0.04-0.68) and fewer deaths at 15 and 30 days (HR, 0.37; 95% CI, 0.14-0.99 and HR, 0.19; 95% CI, 0.07-0.54).
"Enoxaparin prescribed once daily results in fewer major bleeds than enoxaparin twice daily," the authors wrote.
Disclosures: The RIETE registry was supported by Sanofi Spain and Bayer Pharma AG.
Trujillo-Santos J, Bergmann JF, Cristiano B, et al. Once vs twice daily enoxaparin for the initial treatment of acute venous thromboembolism [published online January 25, 2017]. J Thromb Haemost. doi:1111.jth.13616