Tinzaparin realistic alternative to VKAs for secondary prevention of VTE
MedWire News: Long-term treatment with tinzaparin is an effective, well-tolerated alternative to conventional treatment with acenocoumarol for the secondary prevention of venous thromboembolism (VTE) in patients with pulmonary embolism (PE), Spanish researchers report.
In their study of 102 patients with PE, Luis Pérez de Llano (Hospital Xeral-Calde, Lugo) and colleagues found no significant differences in the rate of recurrent VTE or major hemorrhagic complications between patients treated with tinzaparin and those treated with acenocoumarol.
"Current interest is focused in searching for an alternative to oral anti-coagulation in order to maintain (or even improve) efficacy and safety without the need for laboratory monitoring," note the researchers, who evaluated the efficacy and safety of long-term treatment with tinzaparin versus acenocoumarol in patients with acute PE.
The patients, with a mean age of 72 years, were randomly assigned to receive either tinzaparin (n=52; 175 IU/kg/day) or international normalized ratio-adjusted acenocoumarol (n=50) for 6 months, after initial treatment with tinzaparin.
During the treatment period, one patient in the tinzaparin group developed recurrent VTE compared with none in the acenocoumarol group, while one patient in each group had a major hemorrhagic complication.
Minor bleeding occurred in six patients treated with acenocoumarol and in none treated with tinzaparin, a difference that was statistically different.
In addition, median hospital length of stay was significantly shorter in the tinzaparin group compared with the acenocoumarol group, at 7 versus 9 days.
The researchers also performed a pharmaco-economic analysis, which revealed that the combined direct and indirect costs were on average €345 (US $473) cheaper for tinzaparin compared with acenocoumarol.
Writing in the journal Blood Coagulation and Fibrinolysis, Pérez de Llano and co-authors conclude that "long-term treatment with tinzaparin can be used safely and effectively in hemodynamically stable patients with PE."
They add: "Furthermore, due to the reduced need for monitoring anticoagulant effects and shorter hospitalization length of stay, tinzaparin is also a viable economic alternative to vitamin K antagonist therapy.".
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By Laura Dean