The potential role of new therapies in deep-vein thrombosis prophylaxis
Review published in Semin Hematol (2001)
Abstract
The value of prophylaxis against venous thromboembolism (VTE) is increasingly accepted in most surgical specialties, although the potential reduction in fatal pulmonary embolism has recently been questioned. The burden of VTE in hospital patients nevertheless remains high, partly attributable to underuse of thromboprophylaxis and partly attributable to occurrence of VTE in high-risk patients because recommended antithrombotic therapies fail to provide full protection. Improved physician education has been shown to increase the application of antithrombotic measures, and research efforts are focused on developing novel antithrombotic agents with greater efficacy and safety in clinical use. Several novel indirect and direct thrombin inhibitors have been investigated. The heparinoid danaparoid has shown superiority over unfractionated heparin in several indications, but only the recombinant hirudin, desirudin, has exhibited greater efficacy than low-molecular-weight heparin (LMWH) in thromboprophylaxis for patients undergoing elective hip-replacement surgery, without increasing the risk of bleeding. Three large-scale clinical trials have shown desirudin to be the most effective thromboprophylactic agent currently available in elective hip-replacement surgery; this agent has now been licensed for use in orthopedic surgery. Research is ongoing into the feasibility of still more effective and convenient therapies, such as oral antithrombins.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
The value of prophylaxis against venous thromboembolism (VTE) is increasingly accepted in most surgical specialties, although the potential reduction in fatal pulmonary embolism has recently been questioned.
Por qué esto importa para la hirudoterapia
Esta revisión analiza la necesidad de mejorar la profilaxis del tromboembolismo venoso (TEV) y destaca nuevos agentes antitrombóticos, incluida la hirudina recombinante desirudina. El resumen señala que tres ensayos clínicos a gran escala demostraron que la desirudina es más eficaz que la heparina de bajo peso molecular (HBPM) en la tromboprofilaxis de la cirugía electiva de reemplazo de cadera, sin aumentar el riesgo de hemorragia, y que la desirudina había sido autorizada para cirugía ortopédica. Esto es relevante para el ámbito de la ASH, ya que se centra en un anticoagulante recombinante derivado de la sanguijuela de uso clínico. La salvedad es que se trata de una revisión narrativa centrada en la profilaxis farmacológica del TEV; aborda la hirudina recombinante como producto farmacéutico, no la terapia con sanguijuelas vivas, y no aporta datos primarios nuevos.
Citación
The potential role of new therapies in deep-vein thrombosis prophylaxis.
Wille-Jørgensen P · Semin Hematol, 2001
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026