Thromb Haemost 1987; 57(01): 092-096
DOI: 10.1055/s-0038-1651069
Original Articles
Schattauer GmbH Stuttgart

Randomized Double-Blind, Placebo Controlled Safety Study of a Low Molecular Weight Heparinoid in Patients Undergoing Transurethral Resection of the Prostate

Hugo ten Cate
The Division of Haemostasis and Thrombosis, Academic Medical Center, Amsterdam, The Netherlands
,
Ch Pieter Henny
The Division of Haemostasis and Thrombosis, Academic Medical Center, Amsterdam, The Netherlands
,
Jan W ten Cate
The Division of Haemostasis and Thrombosis, Academic Medical Center, Amsterdam, The Netherlands
,
Harry R Büller
The Division of Haemostasis and Thrombosis, Academic Medical Center, Amsterdam, The Netherlands
,
Nosjir F Dabhoiwala
*   The Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

Received 11 August 1986

Accepted after revision 27 November 1986

Publication Date:
06 July 2018 (online)

Summary

In preparation for an efficacy study, the effect of the low molecular weight heparinoid Org 10172 on postoperative blood loss was assessed in a randomized double-blind, placebo controlled study in patients undergoing transurethral resection of the prostate (TURP). Org 10172 and placebo were given twice daily as i.v. injection for three postoperative days starting one hour preoperatively. Three doses of Org 10172 (800, 1600, and 2400 anti-Xa units b.d.) were evaluated against placebo in three consecutive patient blocks respectively. Each block consisted of 20 patients, 15 receiving Org 10172 and 5 patients placebo. The study was discontinued after 9 patients of the third block had completed the protocol because of excessive urinary blood loss. Data analysis showed a dose-dependent increase in postoperative haemoglobin loss, this was not significant for the 800 anti-Xa units b. d. dosage but was significant in those patients treated with 1600 (p <0.05) and 2400 anti-Xa units b.d. (p <0.01).

It was concluded that the heparinoid Org 10172 caused a dose dependent increase in urinary blood loss following TURP.

 
  • References

  • 1 Kelton JG, Hirsh J. Bleeding associated with antithrombotic therapy. Sem Hematol 1980; 17: 259-291
  • 2 Hirsh J. Heparin induced bleeding. Nouv Rev Fr Hematol 1984; 26: 261-266
  • 3 Carter CJ, Kelton JG, Hirsh J, Cerskus A, Santos AV, Gent M. The relationship between the haemorrhagic and antithrombotic properties of low molecular weight heparin in rabbits. Blood 1982; 59: 1239-1245
  • 4 Cade JF, Buchanan MR, Boneu B, Ockelford PA, Carter CJ, Cerskus AL, Hirsh J. A comparison of the antithrombotic and haemorrhagic effects of low molecular weight heparin fractions: the influence of the method of preparation. Thromb Res 1984; 35: 613-625
  • 5 Moelker H CT. Heparin and Platelet function. Prog Pharmacol 4/4. Gustav Fischer Verlag, Stuttgart; New York: 1982
  • 6 Thomas DP, Merton RE, Lewis WE, Barrowcliffe TW. Studies in man and experimental animals of a low molecular weight heparin fraction. Thromb Res 1981; 45: 214-218
  • 7 Holmer E, Mattsson C, Nilsson S. Anticoagulant and antithrombotic effects of heparin and low-molecular weight heparin fragment in rabbits. Thromb Res 1982; 25: 475-485
  • 8 Carter CJ, Kelton JG, Hirsh J, Gent M. Relationship between the antithrombotic and anticoagulant effects of low molecular weight heparin. Thromb Res 1981; 21: 169-174
  • 9 Ockelford PA, Carter CJ, Mitchell L, Hirsh J. Discordance between the anti-Xa activity and the antithrombotic activity of an ultra-low molecular weight heparin fraction. Thromb Res 1982; 28: 401-409
  • 10 Salzman EW, Rosenberg RD, Smit MH, Lindlow JN, Favreau L. Effect of heparin and heparin fractions on platelet aggregation. J Clin Invest 1980; 65: 64-73
  • 11 Meuleman DG, Hobbelen P MJ, van Dedem G, Moelker H CT. A novel antithrombotic heparinoid (Org 10172) devoid of bleeding inducing capacity: a survey of its pharmacological properties in experimental animal models. Thromb Res 1982; 27: 353-363
  • 12 ten Cate H, Henny ChP, Büller HR, ten Cate JW, Magnani HN. Use of a heparinoid in patients with haemorrhagic stroke and thromboembolic disease. Ann Neurol 1984; 15: 268-270
  • 13 Henny ChP, ten Cate H, ten Cate JW, Surachno S, van Bronswijk H, Wilmink JM, Ockelford PA. Use of a new heparinoid as anticoagulant during acute haemodialysis of patients with bleeding complications. Lancet 1983; I 890-893
  • 14 Jansen HJ, Berseus O, Johansson JE. A simple photometric method for determination of blood loss during transurethral surgery. Scand J Urol Nephrol 1978; 12: 1-5
  • 15 ten Cate H, Lamping RJ, Henny ChP, Prins A, ten Cate JW. Automated amidolytic method for determining heparin, a heparinoid and a low -M, heparin fragment based on their anti-Xa activity. Clin Chem 1984; 30: 860-864
  • 16 Biggs R. Human blood coagulation, haemostasis and thrombosis (ed 2). 1972. Oxford: Blackwell Scientific Publications;
  • 17 Sleight MW. The effect of prophylactic subcutaneous heparin on blood loss during and after transurethral prostatectomy. Br J Urol 1982; 54: 164-165
  • 18 Kass EJ, Sonda P, Gershon C, Fisher CP. The use of prophylactic low dose heparin in transurethral prostatectomy. J Urol 1978; 120: 186-187
  • 19 Bejjani BB, Chen D CP, Nolan NG, Edson M. Minidose heparin in transurethral prostatectomy. Urology 1983; 22: 251-254
  • 20 Henny ChP, ten Cate H, Moulijn AC, ten Cate JW, Sie TH, Warren P, Buller HR. A randomized blind study comparing standard heparin and a new low molecular weight heparinoid in cardiopulmonary bypass surgery in dogs. J Lab Clin Med 1985; 106: 187-196
  • 21 Schmitz-Huebner U, Bunte H, Freise G, Reers B, Ruschmeyer C, Sherer R, Schulte H, van de Loo J. Clinical efficacy of low molecular weight heparin in postoperative thrombosis prophylaxis. Klin Wochenschr 1984; 62: 349-353
  • 22 Koller M, Schoch U, Largiader F, Felten Av. Increased bleeding with a low molecular weight heparin (LMWH) fragment (7500 anti-Xa IU/d) used as thrombosis prophylaxis in general surgery. Thromb Haemostas 1985; 54: 92 (Abstr)
  • 23 Bergqvist D, Burmark US, Frisell J, Hallbook T, Lindblad B, Risberg B, Torngren S, Wallin G. Low molecular weight heparin once daily compared with conventional low dose heparin twice daily. A prospective double-blind multicentre trial on prevention of postoperative thrombosis. Br J Surg 1986; 73: 204-208
  • 24 Melchior J, Valk WL, Foret JD, Mebust WK. Transurethral prostatectomy: computerized analysis of 2223 consecutive cases. J Urol 1974; 112: 634-642
  • 25 Fernandez F, Van Ryn J, Ofosu FA, Hirsh J, Buchanan MR. The hemorrhagic and antithrombotic effects of dermatan sulfate. Thromb Haemostas 1985; 54: 61 (Abstr)