The Pharmaceutical Journal
Vol 271 No 7257 p39
12 July 2003

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New England Journal of Medicine abstract (more)

Thrombosis seen less frequently in cancer patients on dalteparin

The low-molecular-weight heparin, dalteparin (Fragmin), is more effective than warfarin for preventing recurrent venous thromboembolism in patients with cancer, say researchers.

In a study of 672 cancer patients who had been diagnosed with a thrombotic event (deep vein thrombosis or pulmonary embolism), subsequent prophylaxis with dalteparin reduced the incidence of further thromboembolism by a half (27 of 336 patients treated with dalteparin, versus 53 of 336 patients treated with an oral anticoagulant). The reduced incidence of thromboembolism was achieved without an increased frequency of bleeding (New England Journal of Medicine 2003;349:146).

In an accompanying editorial, Dr Rodger Bick of the University of Texas Southwestern medical school, Dallas, says: "[The trial] provides clear evidence that low-molecular weight heparin should become the therapeutic and prophylactic agent of choice in cancer-associated thromboembolic disease." He adds that the cost of such therapy has been previously overestimated, pointing out that it is generally unnecessary to monitor its anticoagulant effect. The reduced frequency of thrombosis also lowers the overall cost of medical care, he says (ibid, p109).