Autor: |
C J, van Dongen, M R, Mac Gillavry, M H, Prins |
Rok vydání: |
2005 |
Předmět: |
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Zdroj: |
The Cochrane database of systematic reviews. (3) |
ISSN: |
1469-493X |
Popis: |
In the initial treatment of venous thromboembolism (VTE) low molecular weight heparin (LMWH) is administered once or twice daily. A once daily treatment regimen is more convenient for the patient and may optimise home treatment. However it is not clear whether a once daily treatment regimen is as safe and effective as a twice daily treatment regimen.The objective of this review was to compare the efficacy and safety of once daily administration to a twice daily administration of LMWH.Trials were identified through the Specialised Register of the Cochrane Peripheral Vascular Diseases Group (last searched May 2001), the Cochrane Controlled Trials Register (CCTR/CENTRAL) (last searched Issue 1, 2002), by hand-searching other relevant journals, by checking cross-references and through personal communication with experts.Randomised clinical trials in which a once daily treatment regimen with LMWH is compared to a twice daily regimen in the initial treatment of patients with venous thromboembolism.Two reviewers assessed trials on criteria for inclusion and extracted the data independently.Five studies were included with a total of 1508 patients. The pooled data showed a statistically non-significant difference in recurrent venous thromboembolism between the two treatment regimens (OR 0.82; 0.49 - 1.39). A comparison of major haemorrhagic events (OR 0.77; 0.40 - 1.45) and mortality (OR 1.14; 0.62 - 2.08) also showed a statistically non-significant difference between the two treatment regimens.Once daily treatment with LMWH is as effective and safe as twice daily treatment with LMWH. However, the 95% confidence interval implies that there is a possibility that the risk of recurrent VTE might be higher when patients are treated once daily. Hence the decision to treat the patient with a once daily regimen will depend on the evaluated balance between increased convenience and the potential for a lower efficacy. |
Databáze: |
OpenAIRE |
Externí odkaz: |
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