New synthetic antithrombotic drug could reduce dvt risk after h...( nd concludes: Improved efficacy and sy...),Health

nd, concludes: Improved efficacy and synthetic nature (compared with heparins, including low-molecular-weight heparin, that are extracted from animal material) are considerable assets for the new drug. Its widespread use in clinical practice, however, will depend on the overall benefit-risk and cost analysis. Major bleeding was about 1% more with fondaparinux than with enoxaparin. Is the synthetic pentasaccharide more effective while being more dangerous? Indeed, symptomless deep-vein thrombosis may not trouble most surgeons and patients . However, the surgeon is always held responsible for a major bleeding complication. Thus, fragile patients (eg, those underweight, with impaired renal function, or any haemorrhagic tendency) should probably not receive fondaparinux, especially because only a single fixed dose regimen has been studied in phase III. Nonetheless, fondaparinux may herald a new era in effective prevention of venous thromboembolism, despite the potential for increased bleeding. As with any new drug, fondaparinux should be used cautiously and only in patients who reflect the population of the clinical trials in which the drug was evaluated.

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Contact: Richard Lane
richard.lane@lancet.com
44-20-7424-4949
Lancet
16-May-2002

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