Year 2010 Vol. 18 No 6

IN ASSISTANCE TO PRACTICIONER

TIKHON D.S., OGANESYAN N.A.

FONDAPARINUX AS A NEW EFFECTIVE ANTICOAGULANT FOR VENOUS THROMBOEMBOLISM PREVENTION IN SURGERY

Fondaparinux is the first of a class of selective antithrombin-dependent factor Xa inhibitors, it is a synthetic analogue of the critical pentasaccharide sequence required for binding heparin molecules to Anthitrobin. It does not interact with plasma proteins other than antithrombin, leading to a predictable pharmacokinetics, which renders monitoring and dose adjustment unnecessary. Given subcutaneously, fondaparinux demonstrates 100% bioavailability with a half-life of 17 hours permitting once-daily injection. Fondaparinux is more effective than low molecular weight heparin (LMWH) for prevention of venous thromboembolism (VTE) following major orthopedic surgery and at least as effective as for LMWH following major abdominal surgery. Several thousands of patients have been studied and the substance is safe, although a slightly higher frequency of bleedings is found than in patients on LMWH. Other side-effects are rare. Fondaparinux is cost saving and sometimes cost neutral when compared with enoxaparin. It was recommended with a Grade1A rating for VTE prophylaxis in major orthopedic and abdominal surgery. Moreover Fondaparinux was the only anticoagulant recommended with a Grade 1A rating for hip-fracture surgery.

Keywords: fondaparinux, venous thrombosis, venous thromboembolism, surgery, orthopedic surgery, major abdominal surgery, bleeding complications
p. 139 150 of the original issue
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