Fondaparinux (Arixtra) is a novel antithrombin-binding pentasaccharide that inhibits factor Xa without inhibiting thrombin. It has been shown to be safe and effective for antithrombotic prophylaxis following orthopedic surgery (see Chapter 17). Fondaparinux likely does bind to PF4 through charge interactions, and in suprather-apeutic concentrations will even disrupt PF4/heparin complexes (Greinacher et al., 2006). Further, in systematic studies of anti-PF4/heparin antibody formation performed using blood samples from RCTs comparing fondaparinux and enoxaparin

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