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Therapeutics
Review: low molecular weight heparin reduces recurrent venous thromboembolism better than unfractionated heparin

https://doi.org/10.1136/ebm.10.3.80

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    van Dongen CJ, van den Belt AG, Prins MA, et al. Fixed dose subcutaneous low molecular weight heparins versus adjusted dose unfractionated heparin for venous thromboembolism. Cochrane Database Syst Rev 2004;(4):CD001100.

    
 
 Q In patients with acute venous thromboembolism (VTE), is fixed dose subcutaneous low molecular weight heparin (LMWH) more effective than adjusted dose unfractionated heparin (UFH) for reducing symptomatic recurrent VTE?

    Clinical impact ratings IM/Ambulatory care ★★★★★☆☆ Internal medicine ★★★★★☆☆ Haematology ★★★★☆☆☆

    METHODS

    Embedded ImageData sources:

    Cochrane Peripheral Vascular Diseases Specialized Register (July 2004), the Cochrane Central Register of Controlled Trials (Issue 3, 2004), LILACS, bibliographies of relevant articles, researchers, and pharmaceutical companies.

    Embedded ImageStudy selection and assessment:

    randomised controlled trials (RCTs) that compared fixed dose subcutaneous LMWH with adjusted dose UFH (intravenous or subcutaneous) for initial treatment (usually the first 5–14 d) in patients with acute VTE. After selection, each study was assessed for adequacy of concealment of allocation before randomisation.

    Embedded ImageOutcomes:

    recurrent symptomatic VTE, major haemorrhage, and all cause mortality.

    MAIN RESULTS

    22 RCTs (n = 8867) met the selection criteria. Categories of VTE included symptomatic deep venous …

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    Footnotes

    • For correspondence: Professor M Prins, University of Maastricht, Maastricht, The Netherlands. mh.prinsepid.unimaas.nl

    • Source of funding: Scottish Executive UK.