Obesity

Fondaparinux dosing in obese patients nursing: Anticoagulants and Antiplatelets

Background: The MATISSE trials demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE.

Listing a study does not mean obese patients has patienfs evaluated by the U. Phase 2. As with prophylactic LMWH, anti-Xa levels can be monitored, but a strongly validated therapeutic range for anti-Xa levels in any disease state is lacking. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Fondaparinux sodium Arixtra is an FDA- approved medication used in the prevention of deep venous thrombosis DVT at the time of orthopedic or abdominal surgery, as well as for the treatment of DVT and pulmonary embolism PE. Actual Study Completion Date :.

  • Study Description.

  • Streeter, Pharm.

  • Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

  • Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Study Start Date :.

Author notes

Related articles in Web of Science Google Scholar. Treatment groups had similar characteristics. Cite Cite Larissa Martinez, Pharm. Address correspondence to Dr. Jessica C.

The incidences of recurrence and major bleeding were similar for each patient subset of weight and BMI for both fondaparinux and heparin treatment groups. Thank you for submitting a comment on this article. To purchase short term access, please sign in to your Oxford Academic account above. View Metrics.

You could not be signed in. Your comment will be reviewed and published at the journal's discretion. Sign In or Create an Account. Email alerts Article activity alert. Issue Section:. Close mobile search navigation Article Navigation. No documented thromboembolic events occurred during hospitalization in the cases evaluated.

Study record managers: refer to the Data Element Definitions if submitting registration or results information. Several trials, with varying definitions of obesity, have been published suggesting that modified dosing regimens may be necessary to rapidly achieve a therapeutic aPTT on UFH, without risking excessive anticoagulation see Table Participants will be administered two different doses of the medication with a 2-week interval in between, then blood will be drawn in various intervals throughout the next 48 hours to see which dose provides the best therapeutic levels. There was no difference in day death or MI, or bleeding in relation to BMI, indicating that there was no significant interaction between treatment effect with enoxaparin or UFH, the comparator drug in the original study. Save this study. Please refer to this study by its ClinicalTrials. Secondary Outcome Measures : Comparisons of the pharmacokinetic parameters of morbidly obese participants receiving 2.

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Intravenous fosfomycin as salvage therapy for osteomyelitis caused by multidrug-resistant Pseudomonas aeruginosa. Buller, MDHarry R. Latest Issue Alert. Background: The MATISSE trials demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE.

This article is also available for rental through DeepDyve. Volume Your comment will be reviewed and published at the journal's discretion. Medians and ranges for weight and BMI were compared for patients suffering either recurrence or major bleeding. Sign In Forgot password?

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View Metrics. Conclusion: Once-daily fondaparinux is at least as effective and as safe as standard therapies in the initial treatment of DVT or PE in obese patients. This article is also available for rental through DeepDyve.

For general information, Learn About Clinical Studies. Department of Health and Human Services. Several oese have shown that VTE events are more common in obese patients. Overall, utilizing TBW for dosing therapeutic UFH was not found to cause more bleeding, but in practice the infusion rate is often capped or decreased in obese patients. Outcome Measures.

If you originally registered with a username please use that to sign in. Buller, MDHarry R. This article is also available for rental through DeepDyve. Skip Nav Destination Content Menu. Close mobile search navigation Article Navigation.

The purpose of this study is to assess the pharmacokinetic properties of fondaparinux in morbidly obese volunteers. Fondaparinux is fondaparijux subcutaneous Xa inhibitor that is indicated for prevention and treatment of VTE. Read our disclaimer for details. Pharmacodynamic PD studies suggest that enoxaparin 0. Log In or Register to continue. The dosing strategies for anticoagulants often depend on indication, but both standard and weight-based dosing strategies necessitate additional considerations for obese patients.

All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. View Metrics. Google Scholar. Methods: Fondaparinux was administered at a once-daily subcutaneous dose of 7.

  • Interventional Clinical Trial. The optimal anti-Xa level for decreasing VTE events has not been clearly supported by robust literature and is primarily based on expert opinion.

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  • Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information.

  • Fondaparinux Sodium Arixtra Pharmakinetics.

Venous Thrombosis Pulmonary Embolism. Layout table for additonal information ClinicalTrials. Study Description. A study by Scholten and colleagues found that enoxaparin 40 mg twice daily decreased DVT in comparison to 30 mg twice daily, with no major difference in bleeding. Search for terms.

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The pentasaccharide fondaparinux is an anti-thrombotic agent used in the prophylaxis of venous thromboembolism fondaparinux dosing in obese patients nursing orthopedic or abdominal surgery. Therapeutic dosing of LMWH is weight based, and studies have historically not included dose capping for obese patients. Primary Outcome Measures : The pharmacokinetic properties of fondaparinux sodium in morbidly obese individuals. Like many agents, most of the anticoagulants were originally studied in populations that included a minimal number of obese patients. Drug: Fondaparinux Sodium. The dosing strategies for anticoagulants often depend on indication, but both standard and weight-based dosing strategies necessitate additional considerations for obese patients. This is a prospective crossover, randomized study with a 2-week washout period comparing two dosing regimens of fondaparinux in morbidly obese volunteers.

  • Detailed Description:. One study found that a reduced dose of enoxaparin 0.

  • Matthew Borrego, Ph.

  • Applicable studies to date can be reviewed in Table

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Cited By Web Of Science 2. Article Navigation. To purchase short term access, please sign in to your Kbese Academic account above. Patients nursing Twenty-two thousand and one patients received fondaparinux and received enoxaparin or unfractionated heparin. Sign In. Abstract Background: Selecting initial anticoagulant dose by patient weight for acute pulmonary embolism and deep vein thrombosis has clinical credibility; however, uncertainty remains regarding how to dose obese patients with newer anticoagulants because outcome data are sparse.

Close Modal. Results: The percentage of obese patients was Methods: Fondaparinux was administered at a once-daily subcutaneous dose of 7. Google Scholar. Close Abstract. Author notes Corresponding author. Select Format Select format.

Publication types Randomized Controlled Trial. Background: The MATISSE trials demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE. Sign In. Jessica C.

To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. Like this: Like Loading Contacts and Locations. Study Start Date :. Tags: Demystifying Drug Dosing in Obesity.

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Email alerts Article activity alert. No documented thromboembolic events occurred dsoing hospitalization in the cases evaluated. Advanced Search. Cite Icon Cite. Sign in Don't already have an Oxford Academic account? Related articles in Web of Science Google Scholar. Medians and ranges for weight and BMI were compared for patients suffering either recurrence or major bleeding.

Thus, this section will aim to discuss the literature available for anticoagulant dosing strategies for VTE prophylaxis, therapeutic anticoagulation, and ACS secondary prevention in obese patients. PD studies confirm the need for aptients doses of enoxaparin to achieve target anti-Xa levels reliably in obese surgery and trauma patients. Bariatric surgery carries a mortality rate of 0. Participants will be administered two different doses of the medication with a 2-week interval in between, then blood will be drawn in various intervals throughout the next 48 hours to see which dose provides the best therapeutic levels. Primary Outcome Measures : The pharmacokinetic properties of fondaparinux sodium in morbidly obese individuals.

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Don't already have an Oxford Academic account? It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Author notes Corresponding author. Related articles in Web of Science Google Scholar. Select Format Select format.

Sign In. I agree to the terms and conditions. Cited By Web Of Science 2. New perspectives on propofol allergy. Allison Burnett, Pharm. Email alerts Article Activity Alert.

Tags: Demystifying Drug Dosing in Obesity. Primary Outcome Measures : The pharmacokinetic properties of fondaparinux sodium in bei kindernachrichten obese individuals. Last Update Posted : May 16, With a reported 40, bariatric surgical procedures inand the numbers growing rapidly every year, there is clearly a need for a more effective prophylaxis from DVT and PE. This is a prospective crossover, randomized study with a 2-week washout period comparing two dosing regimens of fondaparinux in morbidly obese volunteers.

For general information, Learn About Clinical Studies. Drug: Fondaparinux Sodium. In addition to questions regarding dosing of LMWH in obese patients, there is ambiguity regarding utility of anti-Xa levels for monitoring the ogese of anticoagulation. Morbidly obese individuals are at high risk for potentially life threatening blood clots around the time of abdominal surgical procedures. Although this study concluded that the standard dose of fondaparinux often resulted in anti-Xa levels below goal, the correlation of anti-Xa levels and clinical outcomes is unclear; thus no recommendations can be made for dose adjustments in obesity at this time.

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Fondaparinux dosing in obese patients nursing You have reached the maximum number of saved studies Study record managers: refer to the Data Element Definitions if submitting registration or results information. Dosung and Antiplatelets. Study Start Date :. Fondaparinux sodium Arixtra is an FDA- approved medication used in the prevention of deep venous thrombosis DVT at the time of orthopedic or abdominal surgery, as well as for the treatment of DVT and pulmonary embolism PE. This is a prospective crossover, randomized study with a 2-week washout period comparing two dosing regimens of fondaparinux in morbidly obese volunteers.

  • The purpose of this study is to assess the pharmacokinetic properties of fondaparinux in morbidly obese volunteers.

  • Google Scholar.

  • Only gold members can continue reading. Like this: Like Loading

  • LMWHs are fully absorbed from subcutaneous tissue, albeit more slowly with increased adipose tissue, and primarily distributed in the intravascular space. The average anti-Xa at steady state was 0.

Although this study concluded that the standard dose of fondaparinux often resulted in obese patients nursing levels below goal, the correlation of anti-Xa levels and clinical outcomes is unclear; thus no recommendations can be made for dose adjustments in obesity at this time. Federal Government. Study Start Date :. National Institutes of Health U. Warning You have reached the maximum number of saved studies One study found that a reduced dose of enoxaparin 0. They also suggested dalteparin and tinzaparin may be dosed once daily, but that enoxaparin may best be dosed twice daily based on a trend toward increased recurrence of VTE with once-daily dosing in one study.

Thus, this study concluded that obesity itself, with enoxaparin dosing reduced in some patients, was not a risk factor for worse bleeding or ischemic outcomes following non-ST elevation ACS, and in fact it may be associated with better outcomes. National Library of Medicine U. Estimated Enrollment :. Currently employed prophylactic methods include unfractionated or low molecular weight heparins in combination with mechanical calf compression.

Hagopian et al. PD studies confirm the need for increased doses of enoxaparin to achieve target anti-Xa levels reliably in obese surgery and trauma patients. Read our disclaimer for details. The dosing strategies for anticoagulants often depend on indication, but both standard and weight-based dosing strategies necessitate additional considerations for obese patients. However, despite the implementation of these standard measures, the reported incidence of fatal PE has ranged from 0.

Study Start Date :. It is clinically imperative to have a predictable anti-Xa level and a predictable DVT prophylactic effect in the morbidly obese whose body weight may vary by as much as 3 to 4 fold higher compared to the average 70 Kg adult. National Library of Medicine U. LMWHs are fully absorbed from subcutaneous tissue, albeit more slowly with increased adipose tissue, and primarily distributed in the intravascular space.

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  • Save this study.

  • Hagopian et al. It is clinically imperative to have a predictable anti-Xa level and a predictable DVT prophylactic effect in the morbidly obese whose body weight may vary by as much as 3 to 4 fold higher compared to the average 70 Kg adult.

  • Methods: Fondaparinux was administered at a once-daily subcutaneous dose of 7.

  • In addition to questions regarding dosing of LMWH in obese patients, there is ambiguity regarding utility of anti-Xa levels for monitoring the degree of anticoagulation. National Institutes of Health U.

Jessica C. I agree to the terms and conditions. Oral Sessions November 16, Sign in via your Institution Sign in. To purchase short term access, please sign in to your Oxford Academic account above.

David Garcia, M. New issue alert. Add comment Cancel. TriCore Reference Laboratories, Albuquerque. Email alerts Article Activity Alert. Conclusion: Once-daily fondaparinux is at least as effective and as safe as standard therapies in the initial treatment of DVT or PE in obese patients. This article is also available for rental through DeepDyve.

Eligibility Criteria. With a obse 40, bariatric surgical procedures inand the numbers growing rapidly every year, there is clearly a need for a more effective prophylaxis from DVT and PE. They will be divided into 7 groups: 3 participants with BMI 35 - Outcome Measures. Study Start Date :.

  • Actual Study Completion Date :.

  • Email alerts Article Activity Alert.

  • Search for terms. A study of enoxaparin 40 mg twice daily compared to 60 mg twice daily achieved average anti-Xa levels of 0.

Read our disclaimer for details. Secondary Outcome Measures : Comparisons of the pharmacokinetic parameters of morbidly obese participants receiving 2. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. They also suggested dalteparin and tinzaparin may be dosed once daily, but that enoxaparin may best be dosed twice daily based on a trend toward increased recurrence of VTE with once-daily dosing in one study. Log In or Register to continue. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. FDA Resources.

Anti-factor Xa concentrations in morbidly obese patients receiving fondaparinux sodium 2. Buller, MDHarry R. Submit Cancel. Cite Cite Larissa Martinez, Pharm.

Publication types Randomized Controlled Trial. Citing articles via Web of Science 9. View Metrics.

Treatment groups had similar characteristics. You could not be signed in. I fondaaprinux to the terms and conditions. Jessica C. Background: The MATISSE trials demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE. This article is also available for rental through DeepDyve.

Actual Study Completion Date :. Secondary Outcome Measures : Comparisons of the nureing parameters of morbidly obese participants receiving 2. Anticoagulants and Antiplatelets. The purpose of this study is to assess the pharmacokinetic properties of fondaparinux in morbidly obese volunteers. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below.

Helpful Tips. Anticoagulants and Antiplatelets. National Library of Medicine U. They also suggested dalteparin and tinzaparin may be dosed once daily, but that enoxaparin may best be dosed twice daily based on a trend toward increased recurrence of VTE with once-daily dosing in one study. Table

Article Navigation. Publication types Randomized Controlled Trial. A stepwise linear regression analysis of selected demographic and clinical nursing indicated that better renal function, male sex, increased BMI, and fewer fondaparinux doses were associated with a greater likelihood of diminished anti-factor Xa activity in the cases evaluated. TriCore Reference Laboratories, Albuquerque. Issue Section:. Anti-factor Xa values in morbidly obese patients receiving standard doses of fondaparinux sodium for the prevention of venous thromboembolism VTE were analyzed in a retrospective chart evaluation.

Drug Information available for: Fondaparinux Fondaparinux sodium. The purpose of this study is to assess the pharmacokinetic properties of fondaparinux in morbidly obese volunteers. The largest patient included in the study was Venous Thrombosis Pulmonary Embolism. A study of enoxaparin 40 mg twice daily compared to 60 mg twice daily achieved average anti-Xa levels of 0. There was no difference in day death or MI, or bleeding in relation to BMI, indicating that there was no significant interaction between treatment effect with enoxaparin or UFH, the comparator drug in the original study.

Fondaparinux Sodium Arixtra Pharmakinetics. Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information. Like many agents, most of the anticoagulants were originally studied in populations that included a minimal number of obese patients.

Cite Icon Cite. Results: Twenty-two thousand and one patients received fondaparinux and received enoxaparin or unfractionated heparin. Oral Sessions November 16, Blood 11 : Abstract Purpose. View Large. View Metrics.

Comparison of the pharmacokinetic parameters of the 2. Talk fondapafinux your doctor and family members or friends about deciding to join a study. Therapeutic dosing of LMWH is weight based, and studies have historically not included dose capping for obese patients. Last Update Posted : May 16, As with many medications, therapeutic dosages have not been fully investigated for the morbidly obese population.

Anti-factor Xa concentrations in morbidly obese patients receiving fondaparinux sodium 2. Conclusions: The current recommended doses of fondaparinux and heparins for the treatment of venous thromboembolism appear to provide similar protection against recurrence and major bleeding to one another and to obese and non-obese patients. Email alerts Article activity alert. Matthew Borrego, Ph. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. Sign In Forgot password?

Secondary Outcome Measures : Comparisons of the pharmacokinetic parameters of morbidly obese participants patientx 2. Study record managers: refer to the Data Element Definitions if submitting registration or results information. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Similar studies on low molecular weight heparins, such as enoxaparin and dalteparin, showed predictable anti-Xa activity with weight-based dosing in the morbidly obese. Save this study.

Like many agents, most of the anticoagulants were originally studied in populations that included a minimal number of obese patients. Several trials, with varying definitions of obesity, have been published suggesting that patietns dosing regimens may be necessary to rapidly achieve a therapeutic aPTT on UFH, without risking excessive anticoagulation see Table Read our disclaimer for details. It is clinically imperative to have a predictable anti-Xa level and a predictable DVT prophylactic effect in the morbidly obese whose body weight may vary by as much as 3 to 4 fold higher compared to the average 70 Kg adult. Study Description.

Actual Study Completion Date :. National Library of Medicine U. Phase 2. Log In or Register to continue. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Eligibility Criteria. In addition to questions regarding dosing of LMWH in obese patients, there is ambiguity regarding utility of anti-Xa levels for monitoring the degree of anticoagulation.

Estimated Enrollment :. The largest patient included in the study was This is a prospective crossover, randomized study with a 2-week washout period comparing two dosing regimens of fondaparinux in morbidly obese volunteers.

  • Drug Information available for: Fondaparinux Fondaparinux sodium. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

  • Abstract Background: Selecting initial anticoagulant dose by patient weight for acute pulmonary embolism and deep vein thrombosis has clinical credibility; however, uncertainty remains regarding how to dose obese patients with newer anticoagulants because outcome data are sparse. Email alerts Article Activity Alert.

  • Interventional Clinical Trial.

  • You do not currently have access to this article.

  • Comparison of the pharmacokinetic parameters of the 2. Actual Study Completion Date :.

Jessica C. This article is also available for rental through DeepDyve. This Site. Results: Twenty-two thousand and one patients received fondaparinux and received enoxaparin or unfractionated heparin. Volume You could not be signed in.

Therapeutic LMWH Dosing in VTE —Ina review of literature on LMWH dosing in obesity and renal impairment summarized fondaaparinux data available for both prophylactic and therapeutic dosing, making evidence-based recommendations for clinical practice. Our goal is to study the therapeutic blood levels, after 2 different dosages of the medication are given to morbidly obese volunteers. Similar to the recent PD studies, the initial and final enoxaparin doses were significantly lower in the morbidly obese population. This is a prospective crossover, randomized study with a 2-week washout period comparing two dosing regimens of fondaparinux in morbidly obese volunteers.

The incidences of recurrence and major bleeding were similar for each patient subset of weight and BMI for both fondaparinux and heparin treatment groups. No documented thromboembolic events occurred during hospitalization in the cases evaluated. Purchase Subscription prices and ordering Short-term Access To purchase short term access, please sign in to your Oxford Academic account above.

Cited By Web Of Science 2. Skip Nav Destination Content Menu. Treatment groups had similar characteristics. Larissa Martinez, Pharm. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic.

Tags: Demystifying Drug Dosing in Obesity. As with many medications, therapeutic dosages have not been fully investigated for the morbidly obese population. Please refer to this study by its ClinicalTrials. Secondary Outcome Measures : Comparisons of the pharmacokinetic parameters of morbidly obese participants receiving 2.

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