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8/15/2000

Heparins Offer Similar Effectiveness; Outpatient Use May Require Extra Monitoring

Katherine M. Bennett

While low-molecular-weight (LMW) heparins seem at least as effective as heparin in treating venous thromboembolism, their use outside of hospitals may require rigorous monitoring, according to a meta-analysis of 13 studies.

Researchers found no significant differences in risk between LMW and unfractionated heparins for recurrent venous thromboembolism, pulmonary embolism, bleeding, or thrombocytopenia. The risk for major bleeding from LMW heparins, however, seems to be influenced by the treatment site, with inpatients having a lower risk than outpatients for major bleeding, relative to unfractionated heparin therapy. Once-daily and twice-daily doses of LMW heparins do not differ in risk for adverse outcomes. 

Writing in the Jan. 24 issue of Archives of Internal Medicine, the researchers stated that once-daily administration of LMW heparins offers similar safety and effectiveness as twice-daily administration. Also, any LMW heparin product would be reasonable to use if given at the same dosages mentioned in the 13 studies. To view the article, go to archinte.ama-assn.org/issues/v160n2/pdf/ioi81163.pdf.