Retrospective evaluation of a pharmacokinetic program for adjusting enoxaparin in renal impairment

Kruse, Michael; Lee, Jeremy J.

doi:10.1016/j.ahj.2004.04.015

Cited by 47 publications

(33 citation statements)

References 22 publications

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“…However, under-dosage may increase the risk of VTE in this population [8,9]. Although dose recommendations for the use of enoxaparin in patients with severe RI had been derived from several studies with therapeutic [10,11] and prophylactic [12] dosage, these data cannot directly be applied to other LMWH due to different pharmacokinetic properties of each drug [13].…”

Section: Introductionmentioning

confidence: 99%

“…Primary objectives were peak anti-Xa levels and adjusted anti-Xa levels, adjustment being carried out for dose and body weight. Results: A total of 42 patients could be analyzed during a median of 10 days (interquartile range IQR 4-13, range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. In all groups, adjusted peak anti-Xa levels were not different on day 10 compared with day 1.…”

Section: )2mentioning

confidence: 99%

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Study of bioaccumulation of dalteparin at a prophylactic dose in patients with various degrees of impaired renal function

Schmid

Brodmann

Fischer

et al. 2009

Journal of Thrombosis and Haemostasis

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To cite this article: Schmid P, Brodmann D, Fischer AG, Wuillemin WA. Study of bioaccumulation of dalteparin at a prophylactic dose in patients with various degrees of impaired renal function. J Thromb Haemost 2009; 7: 552-8.Summary. Background: Low-molecular-weight heparins (LMWH) have been shown to be effective and safe for prophylaxis of thromboembolic diseases. However, issues regarding safety and optimal use of LMWH arise in patients with renal insufficiency (RI). Objectives: To compare pharmacokinetic data of dalteparin for up to 3 weeks in patients with various degrees of RI. Patients and methods: Patients from general medical and surgical wards were included in this prospective cohort study and divided into three groups according to renal function: A = normal (GFR ‡ 60 mL min m )2). Dalteparin was injected s.c. once daily at a prophylactic dose. Peak anti-Xa activity levels (anti-Xa) were measured 4 ± 1 h after injection on day 1 and every third day up to 3 weeks. Primary objectives were peak anti-Xa levels and adjusted anti-Xa levels, adjustment being carried out for dose and body weight. Results: A total of 42 patients could be analyzed during a median of 10 days . In all groups, adjusted peak anti-Xa levels were not different on day 10 compared with day 1. No bioaccumulation >30% could be found up to day 10 even in patients with severe RI. Conclusion: The use of dalteparin at a prophylactic dose was not associated with a bioaccumulation >30% even in patients with severe renal insufficiency during a median follow-up of 10 days (IQR 4-13, range 1-20).

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Section: Introductionmentioning

confidence: 99%

Section: )2mentioning

confidence: 99%

Study of bioaccumulation of dalteparin at a prophylactic dose in patients with various degrees of impaired renal function

Schmid

Brodmann

Fischer

et al. 2009

Journal of Thrombosis and Haemostasis

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“…19 Patients with renal insufficiency form a large portion of the ACS patient population, with a prevalence varying from 13.2% for patients with GFR below 30 ml/min to 42% for patients with GFR between 30 and 70 ml/min. 23,24 Furthermore, it has been shown that patients with renal failure benefit from an invasive strategy, although they are in fact at higher risk for bleeding, especially when dose restriction is not applied. 25 Patients aged 75 years and above Age above 75 years has been shown to be an independent risk factor for bleeding complications and worse outcome.…”

Section: Renal Failurementioning

confidence: 99%

Guideline adherence for antithrombotic therapy in acute coronary syndrome: an overview in Dutch hospitals

Kikkert

Piek²,

Winter³

et al. 2010

NHJL

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Objective. To assess current Dutch antithrombotic treatment strategies for acute coronary syndrome (ACS) in light of the current European Society of Cardiology (ESC) guidelines. Methods. For every Dutch hospital with a coronary care unit (CCU) (n = 93) a single cardiologist was interviewed concerning heparin, thienopyridine and GP IIb/IIIa inhibitor (GPI) treatment. In each hospital, we randomly approached one cardiologist assuming equal policy among physicians employed at the same hospital.

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“…93 Furthermore, some evidence supports downward dose adjustments of enoxaparin in the management of patients with C Cr of 30 to 60 mL/ min. 94 Some data are available with respect to the safety of dalteparin and tinzaparin in patients with renal insufficiency. In a small study of patients (N=22) treated with dalteparin, mean anti-Xa activity was similar between patients with renal impairment (mean C Cr, 26 mL/min; range, 16-38 mL/min) and those with normal renal function (C Cr >80 mL/min).…”

Section: Therapies For Prophylaxis or Treatment Of Vte In Patients Wimentioning

confidence: 99%

Venous Thromboembolic Disease

Streiff¹,

Bockenstedt²,

Cataland³

et al. 2013

J Natl Compr Canc Netw

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OverviewVenous thromboembolism (VTE) is a common and life-threatening condition in patients with cancer.1,2 Results from a retrospective study of hospitalized adult patients with cancer with neutropenia (N=66,106) showed that approximately 3% to 12% of these patients, depending on the type of malignancy, experienced VTE during their first hospitalization.1 In a recent health claims database analysis of patients undergoing chemotherapy for solid tumors in the ambulatory setting (N=17,284), VTE NCCN Venous Thromboembolic Disease Clinical Practice Guidelines in Oncology AbstractVenous thromboembolism (VTE) remains a common and life-threatening complication among patients with cancer. Thromboprophylaxis can be used to prevent the occurrence of VTE in patients with cancer who are considered at high risk for developing this complication. Therefore, it is critical to recognize the various risk factors for VTE in patients with cancer. Risk assessment tools are available to help identify patients for whom discussions regarding the potential benefits and risks of thromboprophylaxis would be appropriate. The NCCN Clinical Practice Guidelines in Oncology for VTE provide recommendations on risk evaluation, diagnosis, prevention, and treatment of VTE in patients with cancer. (JNCCN 2013;11:1402-1429 NCCN Categories of Evidence and ConsensusCategory 1: Based upon high-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2A: Based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2B: Based upon lower-level evidence, there is NCCN consensus that the intervention is appropriate. Category 3: Based upon any level of evidence, there is major NCCN disagreement that the intervention is appropriate. These guidelines are also available on the Internet. For the latest update, visit NCCN.org.

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Retrospective evaluation of a pharmacokinetic program for adjusting enoxaparin in renal impairment

Cited by 47 publications

References 22 publications

Study of bioaccumulation of dalteparin at a prophylactic dose in patients with various degrees of impaired renal function

Study of bioaccumulation of dalteparin at a prophylactic dose in patients with various degrees of impaired renal function

Guideline adherence for antithrombotic therapy in acute coronary syndrome: an overview in Dutch hospitals

Venous Thromboembolic Disease

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