Keywords
enoxaparin
nadroparin
heparin
prophylaxis of venous thromboembolic complications
network meta-analysis
Full Text
Abstract
Aim: network meta-analysis (NMA) of randomized controlled trials (RCTs) of parnaparin, enoxaparin, supraparin, and unfrac- tionated heparin (UFH) in the regime of short-term courses in small and medium doses for prophylaxis of venous thromboem- bolic complications (VTEC) at surgical and orthopedic interventions in patients with high risk of deep vein thrombosis (DVT).
Materials and methods. Mixed CMA of 21 RCTs of parnaparin, enoxaparin, supraparin and UFH was performed in surgical pa- tients with short-term (1–2 weeks) prophylaxis of VTEС.
Results. Parnaparin reduced significantly the odds of DVT (by 51%), and the odds of «large» bleedings (by 83%) compared with UFH. Both enoxaparin and nadroparin did not demonstrate convincing advantages over UFH concerning the e cacy and the safety. This fact is hardly explained due to the insu cient statistical power of the study.
Conclusion. We conclude that when other things being equal, parnaparin exposes better therapeutic profile resulting par- naparin might to be considered first for VTEC prevention in surgery and orthopedics.
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