A Comparison of Recombinant Hirudin with a Low-Molecular-Weight Heparin to Prevent Thromboembolic Complications after Total Hip Replacement

• Published in: The New England journal of medicine Vol. 337; no. 19; pp. 1329 - 1335
• Main Authors: Eriksson, Bengt I, Wille-Jørgensen, Peer, Kälebo, Peter, Mouret, Patrick, Rosencher, Nadia, Bösch, Peter, Baur, Markus, Ekman, Steffan, Bach, Doris, Lindbratt, Siv, Close, Philippe
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 06.11.1997
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anticoagulants - administration & dosage; Anticoagulants - therapeutic use; Arthroplasty, Replacement, Hip; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Double-Blind Method; Drug therapy; Enoxaparin - administration & dosage; Enoxaparin - therapeutic use; Female; Hip joint; Hirudin Therapy; Hirudins - administration & dosage; Hirudins - analogs & derivatives; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Postoperative Complications - prevention & control; Preventive medicine; Recombinant Proteins - administration & dosage; Recombinant Proteins - therapeutic use; Thrombophlebitis - etiology; Thrombophlebitis - prevention & control; Transplants & implants; Treatment Outcome; Human; Postoperative; Prosthesis; Treatment efficiency; Cardiovascular disease; Low molecular weight heparin; Anticoagulant; Hip; Hirudin; Vascular disease; Prevention; Chemotherapy; Orthopedic surgery; Total; Complication; Subcutaneous administration; Thromboembolism; Comparative study
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199711063371901

Deep-vein thrombosis is a common complication of total hip replacement, and a variety of methods to prevent it have been studied. The rationale for the use of a specific thrombin inhibitor such as recombinant hirudin (desirudin) stems from its direct inactivation of both free and fibrin-bound thrombin; it requires no plasma cofactors in the inhibition of thrombus growth. 1 – 3 Desirudin differs from natural hirudin in the absence of a sulfate group. In two multicenter studies, desirudin (at a dosage of 15 mg twice daily) has been found to be safe and superior to unfractionated heparin (5000 IU three times daily) . . .