Dosing Strategy and Bleeding Risk in VTE: Is Less Frequent Injection Better?

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Patients who took enoxaparin once daily had few major bleeds compared with patients who took enoxaparin twice daily.
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.

Reference 

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

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