The Pharmaceutical Journal
Vol 269 No 7227 p802
7 December 2002

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AstaZeneca (www.astrazeneca.co.uk)
The Lancet (www.thelancet.com)

Thrombin inhibitor more effective than dalteparin for VTE

A direct thrombin inhibitor, given subcutaneously preoperatively (melagatran) and orally postoperatively (ximelagatran), has been found to be more effective than dalteparin (Fragmin) for thromboprophylaxis after total hip or knee replacement. The inhibitor is being developed by AstraZeneca.

In a study of 1,900 patients, venous thromboembolism (VTE) was lower with a regimen of melagatran 3mg twice daily followed by ximelagatran 24mg twice daily, than with dalteparin 5,000iu once daily. Both regimens were given for seven to 10 days. An overall dose-dependent decrease in the risk of VTE was seen in those treated with the inhibitor (Lancet 2002;360:1441).

A spokesman for Pharmacia, manufacturer of dalteparin, commented that dalteparin has the advantage of being given as a once daily injection.