PMID- 18422394
OWN - NLM
STAT- MEDLINE
DCOM- 20080925
LR  - 20181201
IS  - 1175-3277 (Print)
IS  - 1175-3277 (Linking)
VI  - 8
IP  - 2
DP  - 2008
TI  - Fondaparinux sodium: a review of its use in the management of acute coronary 
      syndromes.
PG  - 113-25
AB  - Fondaparinux sodium (Arixtra) is a synthetic, sulfated pentasaccharide, selective 
      factor Xa inhibitor that is indicated in Europe for preventing thrombus formation 
      in patients with acute coronary syndromes (ACS; the focus of this review), 
      including those with ST-segment elevation myocardial infarction (STEMI), 
      non-STEMI (NSTEMI), or unstable angina.The large (n = 20,078), well designed 
      OASIS-5 trial showed that subcutaneous fondaparinux 2.5 mg/day for <or=8 days was 
      noninferior to subcutaneous enoxaparin 1 mg/kg twice daily (once daily in those 
      with renal dysfunction) in reducing death or ischemic events at 9 days and the 
      efficacy was maintained for up to 6 months (study end) in patients with unstable 
      angina or NSTEMI. During this time, major bleeding occurred in fewer fondaparinux 
      than enoxaparin recipients, resulting in a benefit: risk balance favoring 
      fondaparinux. The incidence of death or reinfarction at 30 days was significantly 
      lower in recipients of subcutaneous fondaparinux 2.5 mg/day than in those who 
      received usual care (including unfractionated heparin [UFH] treatment as 
      indicated) in patients with STEMI in the large (n > 12,000) OASIS-6 trial. There 
      were no differences in the incidence of major bleeding between these groups, 
      resulting in a benefit : risk balance favoring fondaparinux. The specificity and 
      selectivity of fondaparinux, combined with its long half-life and 100% 
      bioavailability, allows once-daily anticoagulation without the need for 
      monitoring activated clotting time. Subcutaneous fondaparinux was noninferior to 
      enoxaparin treatment in patients with unstable angina or NSTEMI, and was more 
      effective than usual care in those with STEMI. Fondaparinux has a favorable 
      tolerability profile, particularly with regard to the risk of major bleeding, and 
      limited data suggest that it is more cost effective than enoxaparin in the short 
      term. Thus, overall, clinical evidence suggests that fondaparinux has a valuable 
      place in the treatment of patients with ACS.
FAU - Blick, Stephanie K A
AU  - Blick SK
AD  - Wolters Kluwer Health | Adis, Auckland, New Zealand. demail@adis.co.nz
FAU - Orman, Jennifer S
AU  - Orman JS
FAU - Wagstaff, Antona J
AU  - Wagstaff AJ
FAU - Scott, Lesley J
AU  - Scott LJ
LA  - eng
PT  - Journal Article
PT  - Review
PL  - New Zealand
TA  - Am J Cardiovasc Drugs
JT  - American journal of cardiovascular drugs : drugs, devices, and other 
      interventions
JID - 100967755
RN  - 0 (Anticoagulants)
RN  - 0 (Polysaccharides)
RN  - J177FOW5JL (Fondaparinux)
SB  - IM
EIN - Am J Cardiovasc Drugs. 2008;8(6):427
MH  - Acute Coronary Syndrome/*drug therapy
MH  - Angioplasty, Balloon, Coronary
MH  - Anticoagulants/*administration & dosage/adverse effects/pharmacokinetics
MH  - Clinical Trials as Topic
MH  - Drug Interactions
MH  - Fondaparinux
MH  - Hemorrhage/chemically induced
MH  - Humans
MH  - Polysaccharides/*administration & dosage/adverse effects/pharmacokinetics
RF  - 55
EDAT- 2008/04/22 09:00
MHDA- 2008/09/26 09:00
CRDT- 2008/04/22 09:00
PHST- 2008/04/22 09:00 [pubmed]
PHST- 2008/09/26 09:00 [medline]
PHST- 2008/04/22 09:00 [entrez]
AID - 825 [pii]
AID - 10.1007/BF03256588 [doi]
PST - ppublish
SO  - Am J Cardiovasc Drugs. 2008;8(2):113-25. doi: 10.1007/BF03256588.