Safety of desirudin in thrombosis prevention after total knee arthroplasty: the DESIR-ABLE study
Research article published in American journal of therapeutics (2014)
Abstract
Desirudin, administered 30 minutes before total hip arthroplasty is superior to enoxaparin in preventing proximal deep vein thrombosis (DVT) and pulmonary embolism (PE) with similar bleeding. The purpose of this study was to determine the safety of desirudin in patients undergoing elective total knee arthroplasty (TKA) when the first dose of desirudin was administered the evening after surgery. This is a case series of patients undergoing TKA who received desirudin 15 mg every 12 hours subcutaneously for an average of 5 days with the first dose administered postoperatively. The primary endpoint was major bleeding; secondary endpoints included wound outcomes (oozing and infection) and new symptomatic DVT or PE. Desirudin has a favorable safety profile when administered postoperatively in patients undergoing TKA with no reports of major bleeding, wound ooze, or infection. No patients experienced symptomatic DVT, but 2 patients had PE detected by computed tomography after experiencing atypical symptoms. The safety profile of desirudin is improved when administered postoperatively. Bleeding and wound outcomes seem to occur less frequently than historical desirudin and enoxaparin controls.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Case series of patients undergoing total knee arthroplasty given desirudin 15 mg subcutaneously every 12 hours (first dose postoperatively) found no major bleeding, wound complications, or symptomatic DVT, with two pulmonary emboli detected by CT; safety profile improved over preoperative dosing.
Why This Matters for Hirudotherapy
The abstract describes a case series assessing the safety of desirudin 15 mg every 12 hours subcutaneously for about 5 days after elective total knee arthroplasty, with the first dose administered postoperatively and major bleeding as the primary endpoint. No major bleeding, wound ooze, infection, or symptomatic DVT was reported, although 2 patients had PE detected by computed tomography after atypical symptoms. The authors report a favorable postoperative safety profile and suggest bleeding and wound outcomes may occur less frequently than with historical desirudin and enoxaparin controls. Desirudin is a recombinant hirudin derivative (Graetz et al., 2011); hirudin is the anticoagulant of the medicinal leech. This paper studies the drug, not leech therapy.
Citation
Reference (Vancouver style)
Jove M, Maslanka M, Minkowitz HS, Jaffer AK, DESIR-ABLE Investigators. Safety of desirudin in thrombosis prevention after total knee arthroplasty: the DESIR-ABLE study. Am J Ther. 2014;21(6):496-499. doi:10.1097/MJT.0b013e3182691778. PMID: 23344102
Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.
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