PMID- 21845806
OWN - NLM
STAT- MEDLINE
DCOM- 20110906
LR  - 20171116
IS  - 1128-3602 (Print)
IS  - 1128-3602 (Linking)
VI  - 15
IP  - 8
DP  - 2011 Aug
TI  - Update on low molecular weight heparins at the beginning of third millennium. 
      Focus on reviparin.
PG  - 950-9
AB  - BACKGROUND: This review provides an outline of the main pharmacological and 
      clinical features of low molecular weight heparins (LMWHs) and a wider 
      description of reviparin. The basic pharmacological properties of LMWHs are 
      compared with those of unfractionated heparin, showing clear advantages of the 
      former, mainly as for pharmacokinetic profile. DESIGN: Consequently LMWHs are 
      characterized by a more predictable behaviour. A key issue is the lack of 
      "bioequivalence": LMWHs are in fact distinct chemical entities, with typical 
      pharmacological and clinical profile for each agent. Therefore, they are not 
      reciprocally interchangeable. The efficacy and safety of reviparin, a second 
      generation LMWH, has been evaluated in many clinical trials as both thrombosis 
      prevention and treatment. Reviparin use is documented in general and orthopaedic 
      surgery. In patients undergoing abdominal surgery reviparin resulted more 
      effective and better tolerated than unfractionated heparin (UFH). In total hip 
      replacement patients, reviparin compared favourably with enoxaparin, showing the 
      same efficacy but better safety. In patients who undergone total hip replacement, 
      also the long-term, out of hospital prevention of deep vein thrombosis (DVT) has 
      been proven. CONCLUSIONS: The comparison with acenocoumarol demonstrated that 
      reviparin was more effective in preventing DVT recurrences and far better 
      tolerated than oral anticoagulant treatment. Reviparin was also effective and 
      well tolerated in immobilised patients following leg injury with plaster casts or 
      braces applications. Positive results were also obtained in the treatment of 
      venous thromboembolism in well-designed studies on large patient populations. In 
      this indication reviparin compared favourably with iv UFH. As for the use in 
      cardiology patient, reviparin is at present the only approved LMWH for the 
      prevention of acute thrombotic events in patients undergoing percutaneous 
      transluminal coronary angioplasty.
FAU - Del Bono, R
AU  - Del Bono R
AD  - Haemostasis and Thrombosis Centre, University-Hospital Institute of "Spedali 
      Civili di Brescia", Brescia, Italy. roberto.delbono@tin.it
FAU - Martini, G
AU  - Martini G
FAU - Volpi, R
AU  - Volpi R
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Italy
TA  - Eur Rev Med Pharmacol Sci
JT  - European review for medical and pharmacological sciences
JID - 9717360
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 5R0L1D739E (reviparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Fibrinolytic Agents/adverse effects/pharmacology/*therapeutic use
MH  - Heparin/pharmacology
MH  - Heparin, Low-Molecular-Weight/adverse effects/pharmacology/*therapeutic use
MH  - Humans
MH  - Postoperative Complications/drug therapy/prevention & control
MH  - Risk Factors
MH  - Venous Thrombosis/*drug therapy/*prevention & control
EDAT- 2011/08/19 06:00
MHDA- 2011/09/07 06:00
CRDT- 2011/08/18 06:00
PHST- 2011/08/18 06:00 [entrez]
PHST- 2011/08/19 06:00 [pubmed]
PHST- 2011/09/07 06:00 [medline]
PST - ppublish
SO  - Eur Rev Med Pharmacol Sci. 2011 Aug;15(8):950-9.