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DewDiligence

10/30/07 5:25 PM

#5377 RE: DewDiligence #5376

Lovenox is not a substitute for antithrombin for
patients with HD. Here’s a case study from Poland.

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17966105&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

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Insufficiency of Low Molecular Weight Heparin Prophylaxis in Patients With Hereditary Antithrombin Deficiency

Pneumonol Alergol Pol. 2007;75(3):278-282.

[Article in Polish]

Dybowska M, Kuca P, Gralec R, Burakowski J, Tomkowski WZ.

A 39 year old man with normal, stable blood pressure was admitted to the Cardio-Pulmonary Intensive Care Unit due to diagnosed spiral CT pulmonary embolism (PE) and deep venous thrombosis (DVT). In 1999, a hereditary antithrombin (AT) deficiency was confirmed in the presented case.

In 2006, because of a knee injury, the patient was provided with a plaster cast and primary antithrombotic prophylaxis with low molecular weight heparin (LMWH) (80 mg of enoxaparin) was administered subcutaneously once a day (patient's weight was 80 kg).

Despite prophylaxis PE and DVT occurred after 6 weeks of treatment. The patient was successfully treated with unfractionated heparin, repeated infusions of AT concentrate and oral anticoagulants (OA). Transient pulmonary hypertension documented by echocardiography and hemoptysis complicated course of PE. Secondary prophylaxis with OA, and INR maintenance between 2-3, was successfully continued.
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nivasvs

10/30/07 6:01 PM

#5378 RE: DewDiligence #5376

<On the other hand, the FXa inhibitors being developed by Big Pharma are pills whose economic justification comes mostly from their potential in chronic-use settings.>

Not all the FXa are oral pills nor are they for chronic use.

Example is Sanofi's Otamixaban, an IV administration for ACS indication (Acute Coronary Syndrome).

Sorry for the nitpicking Dew.:)