Clinical Use of Danaparoid in Disorders Other Than HIT

Controlled clinical trials of danaparoid for the routine prophylaxis and treatment of venous thromboembolism in non-HIT patients have confirmed its efficacy as an antithrombotic agent. In eight prospective, randomized, controlled, and assessorblind studies, danaparoid was more effective than other standard antithrombotic agents (e.g., warfarin, dextran, low-dose UFH plus dihydroergotamine) in preventing deep vein thrombosis (DVT) after total hip replacement (Hoek et al., 1992; Leyvraz et al., 1992; Org 10172 Report, 1994; Gent et al., 1996; Comp et al., 1998) or hip fracture surgery (Bergqvist et al., 1991; Gerhart et al., 1991). Danaparoid also compared favorably with LMWH in patients undergoing fractured hip surgery (TIFDED Study Group, 1999). In addition, prospective controlled studies have demonstrated the efficacy of danaparoid for DVT thromboprophylaxis after major thoracic and abdominal surgery for cancer (Cade et al., 1987; Gallus et al., 1993) and after spinal cord injury (Merli et al., 1991). Danaparoid (2000 U initial dose iv, then 2000 U twice daily by sc injection) was more effective than UFH in the treatment of DVT (de Valk et al., 1995). Case series also suggest efficacy in patients with disseminated intravascular coagulation (DIC) complicating promyelocytic leukemia (Nieuwenhuis and Sixma, 1986) (danaparoid is approved for treatment of DIC in Japan), as well as in the prevention of fibrin deposition on the dialysis membrane during hemodialysis (Henny et al., 1983; von Bonsdorff et al., 1990).

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