Abstract
Patients with lower limb and pelvic trauma, or undergoing major orthopaedic surgery represent one of the highest risk groups for the development of venous thromboembolism (VTE). A significant number of pharmacological and mechanical agents have been used for the prophylaxis and treatment of VTE. Fondaparinux is a relative new pharmacological agent that selectively binds to antithrombin, and represents a new class of synthetic selective inhibitors of activated factor X. Eleven percent of the fondaparinux-related English language literature, between 2001 and 2007, refers to orthopaedic trauma, and was the sample assessed for this critical analysis review. The clinical studies evaluating the safety, efficacy, and financial implications associated with lower limb orthopaedic trauma show that fondaparinux has comparable results with the well-established use of enoxaparin. However, the scientific community has raised several issues regarding mostly fondaparinuxs safety, timing of its 1st dose, bleeding side effects, duration of administration and lack of a reliable reversing agent. Further trials are necessary focusing on the safety and efficacy of this drug mostly in relation to clinical relevant outcomes and to different fields of trauma surgery (pelvis, long bone fractures and polytrauma patients).
Keywords: Orthopaedic trauma, thromboprophylaxis, venous thromboembolism, fondaparinux
Current Vascular Pharmacology
Title: Fondaparinux for the Prevention or Treatment of Venous ThromboEmbolism Related to Lower Limb Trauma: Evidence Today
Volume: 6 Issue: 2
Author(s): Nikolaos K. Kanakaris, Vassilios S. Nikolaou, Theodoros Tosounidis and Peter V. Giannoudis
Affiliation:
Keywords: Orthopaedic trauma, thromboprophylaxis, venous thromboembolism, fondaparinux
Abstract: Patients with lower limb and pelvic trauma, or undergoing major orthopaedic surgery represent one of the highest risk groups for the development of venous thromboembolism (VTE). A significant number of pharmacological and mechanical agents have been used for the prophylaxis and treatment of VTE. Fondaparinux is a relative new pharmacological agent that selectively binds to antithrombin, and represents a new class of synthetic selective inhibitors of activated factor X. Eleven percent of the fondaparinux-related English language literature, between 2001 and 2007, refers to orthopaedic trauma, and was the sample assessed for this critical analysis review. The clinical studies evaluating the safety, efficacy, and financial implications associated with lower limb orthopaedic trauma show that fondaparinux has comparable results with the well-established use of enoxaparin. However, the scientific community has raised several issues regarding mostly fondaparinuxs safety, timing of its 1st dose, bleeding side effects, duration of administration and lack of a reliable reversing agent. Further trials are necessary focusing on the safety and efficacy of this drug mostly in relation to clinical relevant outcomes and to different fields of trauma surgery (pelvis, long bone fractures and polytrauma patients).
Export Options
About this article
Cite this article as:
Kanakaris K. Nikolaos, Nikolaou S. Vassilios, Tosounidis Theodoros and Giannoudis V. Peter, Fondaparinux for the Prevention or Treatment of Venous ThromboEmbolism Related to Lower Limb Trauma: Evidence Today, Current Vascular Pharmacology 2008; 6 (2) . https://dx.doi.org/10.2174/157016108783955293
DOI https://dx.doi.org/10.2174/157016108783955293 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Leukocyte-Endothelial Cell Interactions: A Therapeutic Target to Ameliorate Inflammatory Diseases
Current Medicinal Chemistry - Anti-Inflammatory & Anti-Allergy Agents Biomarkers Associated with Bleeding Risk in the Setting of Atrial Fibrillation
Current Medicinal Chemistry Advanced Echocardiographic Imaging of the Congenitally Malformed Heart
Current Cardiology Reviews Control of Menopausal Transition through Physical Exercises
Current Women`s Health Reviews Applications of Artificial Neural Networks in Medical Science
Current Clinical Pharmacology Cardiovascular Side Effects of New Antidepressants and Antipsychotics: New Drugs, old Concerns?
Current Pharmaceutical Design Protein Kinase A (PKA) - A Potential Target for Therapeutic Intervention of Dysfunctional Immune Cells
Current Drug Targets COVID-19 in Pediatrics: A Systematic Review of Current Knowledge and Practice
Infectious Disorders - Drug Targets Current Management of Traumatic Rupture of the Descending Thoracic Aorta
Current Cardiology Reviews Carbon Nanotube: A Versatile Carrier for Various Biomedical Applications
Drug Delivery Letters Dendritic Cells in Atherosclerosis
Current Pharmaceutical Design Apoptosis-Regulatory Factors as Potential Drug Targets in the Epithelium of Normal and Inflamed Airways
Current Molecular Pharmacology Blood Brain Barrier in Hypoxic-Ischemic Conditions
Current Neurovascular Research Direct Covalent Modification as a Strategy to Inhibit Nuclear Factor-Kappa B
Current Medicinal Chemistry COVID-19: An Update on Pathogenesis and Treatment
Current Pharmaceutical Design The Impact of the Emerging Genomics Data on the Management of Agerelated Phenotypes in the Context of Cellular Senescence
Current Drug Targets Changing Faces of Transcriptional Regulation Reflected by Zic3
Current Genomics Dealing with the Substance Abuse Epidemic and Infective Endocarditis:Clinical, Immunologic and Pathogenetic Aspects
Current Vascular Pharmacology Salen Mn Complexes Mitigate Radiation Injury in Normal Tissues
Anti-Cancer Agents in Medicinal Chemistry Molecular Basis of Cardioprotection by Erythropoietin
Current Molecular Pharmacology