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Hamostaseologie 2001; 21(03): 143-145
DOI: 10.1055/s-0037-1619516
Original article
Schattauer GmbH

Ist eine Adjustierung an das Körpergewicht für niedermolekulares Heparin zur Therapie der TVT erforderlich?

Is an adjustment to the body weight of low-molecular-weight heparin required for the treatment of DVT?
J. Harenberg
1   I. Medizinische Klinik, Universitätsklinikum Mannheim der Universität Heidelberg
,
H. K. Breddin
2   International Institute of Thrombosis and Vascular Diseases, Frankfurt
,
C. M. Kirchmaier
3   Deutsche Klinik für Diagnostik GmbH, Wiesbaden
› Author Affiliations
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Publication History

Publication Date:
27 December 2017 (online)

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Zusammenfassung

Die Therapie akuter thromboembolischer Erkrankungen mit niedermolekularem Heparin (NMH) in Körpergewichts-adjustierter Dosierung ist gut belegt. Zur Körpergewichts-unabhängigen Dosierung von NMH in der Therapie der akuten tiefen Beinvenenthrombose liegen zwei klinische Studien vor, die die Wirksamkeit und Verträglichkeit von 2-mal 8000 EaXa Certoparin täglich subkutan untersuchten. Vor Therapiebeginn betrug der Marder-Score 23,2 + 8,4 bei Patienten, die zu NMH und 23,9 + 8,9 bei Patienten, die zu unfraktioniertem Heparin (UFH) randomisiert wurden. Nach 10- bis 14-tägiger Therapie waren die Marder-Score-Werte signifikant niedriger unter NMH im Vergleich zu UFH: 18,9 + 9,7 versus 20,5 + 9,9. Die klinischen Ereignisse thromboembolischer Rezidive, schwerer Blutungskomplikationen und der Mortalität waren als zusammengefasstes Ereignis seltener unter NMH als unter UFH: 1,3% versus 5,0% (p = 0,08). Die Ergebnisse aus den zwei Studien zeigen, dass sowohl der Marder-Score als auch die klinisch-symptomatischen Thromboembolierezidive, Blutungskomplikationen und Mortalität im Vergleich zu UFH günstiger sind, wenn Patienten mit akuter tiefer Beinvenenthrombose das NMH Certoparin in fixer Dosierung subkutan erhalten. Eine Körpergewichts-adjustierte Therapie der Venenthrombose ist daher für das NMH Certoparin nicht notwendig. Die Übertragbarkeit der Ergebnisse auf andere NMH bleibt offen.

Summary

Treatment of acute venous thromboembolism with body weight-adjusted low-molecular-weight heparin (LMWH) is effective and safe. Two clinical studies have been performed with fixed dose body weight-independent subcutaneous LMWH Certoparin (twice-daily 8.000 UaXa) compared to unfractionated intravenous heparin (UFH). The Marder Score at entry was not different between the 2 treatment groups: 23.2 + 8.4 (LMW) versus 23.9 + 8.9 (UFH). After a 10-14 days treatment period the Marder Score was significantly lower in patients treated with LMWH compared with UFH: 18.9 + 9.7 versus 20.5 + 9.9. Recurrent venous thromboembolism, major bleeding and mortality were observed less frequently with LMWH (p=0.03). Treatment success of acute venous thromboembolism with body weight-independent LMWH Certoparin has been demonstrated in these two independent clinical trials compared to aPTT-adjusted intravenous UFH. Body weight-independent subcutaneous LMWH Certoparin is almost as effective and safe as intravenous UFH. It remains open, whether these results hold for other LMWHs.

Schlüsselwörter

Venenthrombose - Heparin - niedermolekulares Heparin - Lungenembolie - Certoparin

Keywords

Thrombosis-deep-vein - pulmonary embolism - heparin - low-molecular-weight heparin - certoparin
 

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