The Pharmaceutical Journal
Vol 279 No 7460 p36
14 July 2007

This article
Reprint   Photocopy

  Acrobat Reader

News summary

Venous thromboembolism reduced with extended enoxaparin

Extended thromboprophylaxis reduces the risk of venous thromboembolism (VTE) in acutely ill patients, a new study reveals.

The EXCLAIM (extended clinical prophylaxis in acutely ill medical patients) placebo-controlled trial compared the effect of a five-week course of enoxaparin with a 10-day regimen in over 5,000 patients with reduced mobility. Data presented this week at a meeting of the International Society on Thrombosis and Haemostasis in Geneva show that the extended course reduced VTE events (deep vein thrombosis or pulmonary embolism) by 44 per cent (2.8 per cent versus 4.9 per cent; P=0.0011).

The reduced risk of a VTE event was associated with a reduction in symptomatic VTE (0.3 per cent versus 1.1 per cent; P=0.0044) and asymptomatic proximal deep vein thrombosis (2.5 per cent versus 3.7 per cent; P=0.0319). No significant differences were observed for symptomatic pulmonary embolism or fatal pulmonary embolism. The relative risk reduction of VTE observed with enoxaparin at 38 days was maintained at 90 days (3.0 per cent versus 5.2 per cent; P=0.0015).

Compared with placebo, the rate of major bleeding was higher in the extended enoxaparin arm (0.6 per cent versus 0.15 per cent; P=0.019). There was no difference in all-cause mortality between extended enoxaparin and placebo at six months (10.1 per cent versus 8.9 per cent; P=0.18).