Journal of Thrombosis and Thrombolysis

, Volume 19, Issue 3, pp 173–181

Once-Daily Enoxaparin in The Outpatient Setting Versus Unfractionated Heparin in Hospital for the Treatment of Symptomatic Deep-Vein Thrombosis

  • Beng H. Chong
  • Tim A. Brighton
  • Ross I. Baker
  • Peter Thurlow
  • Choon H. Lee
  • for the ASTH DVT Study Group
Article

DOI: 10.1007/s11239-005-1848-x

Cite this article as:
Chong, B.H., Brighton, T.A., Baker, R.I. et al. J Thromb Thrombolysis (2005) 19: 173. doi:10.1007/s11239-005-1848-x

Abstract

Background: Once- and twice-daily low-molecular-weight heparin administered in hospital have been shown to be effective and safe for treating deep-vein thrombosis. The aim of this study was to compare the efficacy and safety of deep-vein thrombosis treatment using once-daily subcutaneous enoxaparin in the outpatient setting with intravenous unfractionated heparin in hospital.

Methods: This randomized, parallel-group, open-label study was conducted in 18 centers in 4 countries. In total, 298 patients with symptomatic deep-vein thrombosis who were eligible for home treatment were randomized to treatment with enoxaparin in the outpatient setting (1.5 mg/kg subcutaneously once-daily) or unfractionated heparin in hospital (5000 IU bolus and 1250 IU/hour intravenous infusion) for ≥5 days. Clinical endpoints were assessed during a 6-month follow-up period.

Results: Among all patients treated with enoxaparin, there was a trend towards fewer recurrent deep-vein thromboses (1.3% vs. 5.4%; p = 0.060) and pulmonary emboli (1.3% vs. 4.1%; p = 0.17) compared with patients treated with unfractionated heparin. When considering a post-hoc combined endpoint of deep-vein thrombosis and pulmonary embolism, significantly fewer events occurred in the enoxaparin group than in the unfractionated-heparin group (2.7% vs. 8.8%; p = 0.026). The incidences of bleeding events and adverse events in the enoxaparin and unfractionated-heparin groups were similar.

Conclusions: Once-daily subcutaneous enoxaparin in the outpatient setting is at least as effective and as well tolerated as in-hospital intravenous unfractionated heparin for treatment of deep-vein thrombosis.

Key Words

deep-vein thrombosisenoxaparinhome treatmentunfractionated heparin

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Beng H. Chong
    • 1
    • 2
    • 7
  • Tim A. Brighton
    • 3
  • Ross I. Baker
    • 4
  • Peter Thurlow
    • 5
  • Choon H. Lee
    • 6
  • for the ASTH DVT Study Group
  1. 1.Prince of Wales HospitalRandwickAustralia
  2. 2.St. George Clinical SchoolUniversity of New South WalesSydneyAustralia
  3. 3.St. George HospitalKogarahAustralia
  4. 4.Royal Perth HospitalUniversity of Western AustraliaPerthAustralia
  5. 5.Austin and Repatriation Medical CenterHeidelbergAustralia
  6. 6.Nepean HospitalPenrithAustralia
  7. 7.St. George HospitalKogarahAustralia