PMID- 12381232
OWN - NLM
STAT- MEDLINE
DCOM- 20030417
LR  - 20181113
IS  - 0012-6667 (Print)
IS  - 0012-6667 (Linking)
VI  - 62
IP  - 15
DP  - 2002
TI  - Danaparoid: a review of its use in thromboembolic and coagulation disorders.
PG  - 2283-314
AB  - Danaparoid (danaparoid sodium) is a low molecular weight heparinoid which has 
      undergone clinical study for use as continued anticoagulant therapy in patients 
      with heparin-induced thrombocytopenia (HIT), for the prophylaxis and treatment of 
      deep vein thrombosis (DVT), and for the treatment of disseminated intravascular 
      coagulation (DIC). A nonblind study in patients with HIT has reported that 
      complete clinical resolution is significantly more likely in patients receiving 
      danaparoid than in patients receiving dextran 70. In addition, retrospective 
      analyses and noncomparative data support the use of danaparoid for continued 
      anticoagulant therapy in patients with HIT. Studies in patients undergoing hip 
      surgery have shown that danaparoid significantly reduces the incidence of 
      postoperative DVT compared with aspirin, warfarin, dextran 70 and 
      heparin-dihydroergotamine, while additional data suggest no difference between 
      danaparoid, enoxaparin and dalteparin. In patients undergoing abdominal or 
      thoracic surgery for removal of a malignancy, danaparoid reduced the incidence of 
      postoperative DVT compared with placebo, but showed no significant difference 
      when compared with unfractionated heparin (UFH). Two studies have compared 
      danaparoid with UFH in the prophylaxis of DVT following acute ischaemic stroke; 
      twice daily danaparoid was significantly superior to UFH whereas there was no 
      significant difference between a once-daily dosage and UFH. Danaparoid did not 
      differ from UFH in terms of efficacy in the treatment of existing DVT. In all 
      comparative studies examining the efficacy of danaparoid in the prophylaxis or 
      treatment of DVT (versus warfarin, dextran 70, enoxaparin, dalteparin, aspirin, 
      heparin-dihydroergotamine, UFH and placebo), the incidence of haemorrhagic 
      complications did not differ between treatment groups. In patients with DIC, 
      61.9% of those patients receiving danaparoid experienced either disappearance or 
      reduction of symptoms of DIC whereas 62% of those receiving UFH showed either no 
      change or aggravation of their symptoms. There was no significant difference 
      between treatment groups in tolerability or overall improvement of DIC. 
      CONCLUSIONS: Danaparoid is an effective anticoagulant agent which has undergone 
      clinical evaluation in a wide range of disease indications. Current guidelines 
      support the use of danaparoid in prophylaxis of DVT following ischaemic stroke, 
      and in patients who develop HIT. Danaparoid has shown efficacy in DIC, and for 
      DVT prophylaxis in patients undergoing hip surgery although further data are 
      required to establish the role of danaparoid in these indications. In particular, 
      double-blind trials comparing danaparoid with such recommended therapies as the 
      low molecular weight heparins will provide more definitive data on the place of 
      danaparoid in the clinical management of these conditions and ultimately lead to 
      improved patient outcomes.
FAU - Ibbotson, Tim
AU  - Ibbotson T
AD  - Adis International Limited, Mairangi Bay, Auckland, New Zealand. 
      demail@adis.co.nz
FAU - Perry, Caroline M
AU  - Perry CM
LA  - eng
PT  - Journal Article
PT  - Review
PL  - New Zealand
TA  - Drugs
JT  - Drugs
JID - 7600076
RN  - 0 (Anticoagulants)
RN  - 0 (Drug Combinations)
RN  - 24967-94-0 (Dermatan Sulfate)
RN  - 9007-28-7 (Chondroitin Sulfates)
RN  - 9050-30-0 (Heparitin Sulfate)
RN  - BI6GY4U9CW (danaparoid)
SB  - IM
MH  - Anticoagulants/adverse effects/pharmacokinetics/*therapeutic use
MH  - Biological Availability
MH  - Chondroitin Sulfates/adverse effects/pharmacokinetics/*therapeutic use
MH  - Dermatan Sulfate/adverse effects/pharmacokinetics/*therapeutic use
MH  - Disseminated Intravascular Coagulation/*drug therapy
MH  - Drug Combinations
MH  - Heparitin Sulfate/adverse effects/pharmacokinetics/*therapeutic use
MH  - Humans
MH  - Injections, Intravenous
MH  - Injections, Subcutaneous
MH  - Randomized Controlled Trials as Topic
MH  - Thrombocytopenia/*drug therapy
MH  - Treatment Outcome
MH  - Venous Thrombosis/drug therapy/*prevention & control
RF  - 106
EDAT- 2002/10/17 04:00
MHDA- 2003/04/18 05:00
CRDT- 2002/10/17 04:00
PHST- 2002/10/17 04:00 [pubmed]
PHST- 2003/04/18 05:00 [medline]
PHST- 2002/10/17 04:00 [entrez]
AID - 621516 [pii]
AID - 10.2165/00003495-200262150-00016 [doi]
PST - ppublish
SO  - Drugs. 2002;62(15):2283-314. doi: 10.2165/00003495-200262150-00016.