http://www.thrombosisadviser.com 2009-01-05T10:36:47Z

The FDA posted a letter to its Web site on Wednesday from Celgene Corp. warning users of blood-clot busting drug Innohep that new findings suggest the drug may lead to death in the elderly.

Two studies of heart patients showed that the blood thinner clopidogrel (brand name Plavix) was less effective in carriers of certain variants of a gene known to affect how the drug prevents blood clots than non-carriers.

Two articles concerning anticoagulants are worth emphasizing. In February, Kenneth Bauer, MD, editorialized on a new oral anti-Factor Xa agent, rivaroxaban (Xarelto, Bayer/Ortho-McNeil). That it soon may replace parenteral anticoagulants in acute situations, as well as warfarin in more chronic conditions seems likely.

"Rivaroxaban shows great promise as a replacement for warfarin, a medication that has been the only oral anticoagulant for the last 60 years, and can be difficult to dose correctly said," Dr. Margaret Kennedy who is the principal investigator in the two trials.

Heparin-induced thrombocytopenia is a serious complication during antithromboembolic prophylaxis caused by anti-heparin/platelet factor 4 (PF4) complex antibodies. It typically arises 3 to 15 days after the beginning of therapy and may result in an increased risk of arterial and venous thromboembolism.

Thromboembolism is a serious complication of tamoxifen therapy in women with breast cancer. Banked DNA from tamoxifen-treated individuals with breast cancer from the Marshfield Clinic Personalized Medicine Research Project, a population-based DNA repository, was tested for association between incidence of tamoxifen-associated thromboembolic events (TTE) and single nucleotide polymorphisms encoding the estrogen receptors 1,2 (ESR1, ESR2) or drug metabolism enzymes cytochrome P450 2D6 (CYP2D6) and aromatase (CYP19)

VTE is a common complication among advanced colorectal cancer patients and yet this type of toxicity is widely underestimated. In this randomised trial, VTE was the morst frequent grade 3/4 toxicity. Use of an intermittent schedule is associated with a reduced risk of developing VTE.

We sought to determine nationwide, population-based trends in rates of venous thromboembolism (VTE) among hospitalized inflammatory bowel disease (IBD) patients in the United States and to determine its mortality and economic impact.

Congenital protein C deficiency significantly increases the risk of venous thromboembolism, a serious and potentially lethal condition. Protein C levels can be determined by chromogenic, clotting and antigenic assays, each type of assay has differences in specificity and sensitivity to protein C deficiency.

"Incredibly, we found as many as 43 per cent of the patients developed postthrombotic syndrome, and one-third of those had moderate to severe cases," said McGill's Dr. Susan R. Kahn, lead author of the study. "The syndrome is characterized by persistent leg pain and swelling, and in severe cases, patients can develop painful leg ulcers which are very difficult to treat.

A quality-improvement program increased compliance with guidelines for stroke treatment issued by the American Heart Association and American Stroke Association at nearly 800 hospitals, researchers found.

The postthrombotic syndrome occurs frequently after DVT. Patients with extensive DVT and those with more severe postthrombotic manifestations 1 month after DVT have poorer long-term outcomes.

Inhalation of diesel exhaust increases ex vivo thrombus formation and causes in vivo platelet activation in man. These findings provide a potential mechanism linking exposure to combustion-derived air pollution with the triggering of acute MI.

Having immune thrombocytopenia purpura (ITP) appears to increase the risk of thrombosis, a British researcher said here. The risk appears to be primarily associated with venous thromboembolic events, he said at the American Society of Hematology meeting.

PATIENTS going for knee and hip surgeries have to watch out for one possible complication: getting a blood clot that is potentially fatal. In North America now, it's mandatory for such patients to take a blood thinner after the surgery, says Dr Louis Kwong, an orthopaedic surgeon from Harbor-UCLA Medical Center in Torrance, California.

Findings suggest that patients require further information on VTE during their hospitalization to enhance their involvement in VTE prevention and recognition, and that the provision of written, patient-directed information could begin to address that lack of involvement. This study also highlights the need to strengthen the nurses' role in providing patient education about VTE.

The number and types of inpatients given inadequate prophylaxis for venous thromboembolism (VTE) are not known; patients receive less than appropriate prophylaxis with some frequency.

A new palliative care drug was yesterday approved by the agency that determines the medicines made available through the NHS in Scotland. The Scottish Medicines Consortium (SMC) has accepted Xarelto (rivaroxaban), an oral anti-coagulant for the prevention of venous blood clots in adults undergoing elective hip or knee replacement surgery.

Bayer has presented more positive data on Xarelto which the firm says underlines the superior efficacy of the anticoagulant compared with the current gold standard treatment, Sanofi-Aventis´ Lovenox.

Prophylactic treatment with a blood-thinner can markedly reduce -- by about 50% -- the rate of thromboembolism in cancer patients undergoing chemotherapy, researchers found. Currently, such prophylaxis is rarely used for ambulatory cancer patients, in whom the rate of thromboembolism is between 4% and 10%...