Low molecular weight heparins for the prevention and therapy thrombotic complication in oncological patients

O.V. Somonova; A.V. Madzhuga; A.L. Elizarova; I.I. Matveeva

Low molecular weight heparins for the prevention and therapy thrombotic complication in oncological patients

O.V. Somonova¹, A.V. Madzhuga², A.L. Elizarova³, I.I. Matveeva⁴

research article Pages: 59-64

^1,4 Dr.Sc.(Med.), Russian Cancer Research Center of N.N. Blokhin Russian Academy of Medical Sciences, Moscow, Russia
² Ph.D. (Med.), Russian Cancer Research Center of N.N. Blokhin Russian Academy of Medical Sciences, Moscow, Russia
³ Ph.D. (Biol.), Russian Cancer Research Center of N.N. Blokhin Russian Academy of Medical Sciences, Moscow, Russia

Keywords: oncological patients thrombotic complications low molecular weight heparins Zibor (bemiparin)

Abstract

Patients with malignant disease often develop thromboembolic complications, and the incidence of thrombosis complicates anti-cancer therapy and affects survival rates. Low molecular weight heparins are the basis of specific prevention of thromboembolic complications in oncological patients. Zibor (bemiparin) is a second generation low molecular weight heparin, which has the lowest molecular weight (3600 Da), the longest half-life, increased up to 5.3 h and the highest anti-factor Xa-activity (8:1). The clinical studies demonstrated that bemiparin has high effectiveness in the prevention and treatment of thromboembolic complications.

How to cite

Сомонова О.В., Маджуга А.В., Елизарова А.Л., Матвеева И.И. Низкомолекулярные гепарины - препараты выбора для профилактики и лечения тромботических осложнений в онкологии // Вопросы биологической, медицинской и фармацевтической химии. 2014. № 8. С. 59–64.

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[2] Levine M.N., Rickles F., Kakkar A.K. Thrombosis in cancer patients. American Society of Clinical Oncology, 38 Annual Meeting, Orlando. 2002. May 18 - 21. P. 57 - 60.

[3] Geerts W.H., Pineo G.F., Heit J.A. et al. Prevention of venous thromboembolism The Seventh ACCR Conference on Antithrombotic and Thrombolytic Therapy // Chest. 2004. V. 126 (Suppl). P. 338 - 400.

[4] Kakkar A.K., Haas S., Walsh D. et al. Prevention of perioperative venous thromboembolism: outcome after cancer and non-cancer surgery (Abstr.) // Thromb. Haemost. 2001. V. 86 (Suppl). P.0c1732.

[5] Arcelus J.I. Recognizing the risk of VTE in surgical patients. International Surgical Thrombosis Meeting «Optimizing VTE Management in surgical patients» (Abstr.) // Greece. 2007. P. 13 - 17.

[6] Cohen A.T., Nandini B., Wills J.O. et al. VTE prophylaxis for the medical patients: where do we stand - ? A focus on cancer patients // Thromb. Res. 2010. V. 125. Suppl. 2. P. 21 - 29.

[7] Ten C.H., Falanga A. Overview of the postulated mechanisms linking cancer and thrombosis // Pathophysiol. Haemost. Thromb. 2007. V. 36. P. 122 - 130.

[8] Agnelii G., Verso M. Thromboprophylaxis during chemotherapy in patients with advanced cancer // Thrombosis Res. 2010. V. 125. Suppl. 2. P. 17 - 20.

[9] Weitz J.I. Potential of new anticoagulsnts in patients with cancer // Thrombosis Res. 2010. V. 125. Suppl. 2. P. 30 - 35.

[10] Somonova O.V., Madzhuga A.V., Elizarova A.L., Zubrixina G.N. Tromboticheskie oslozhneniya i ix profilaktika v onkologii. Novy'e vozmozhnosti lekarstvennogo lecheniya onkologicheskix bol'ny'x. Materialy' shkoly' po onkologii (ximioterapiya opuxolej). XIV Rossijskij Naczional'ny'j kongress «Chelovek i lekarstvo». M. 2007. S. 135 - 137.

[11] Lee A.Y. The roles of anticoagulants in patients with cancer // Thromb. Res. 2010. V. 125. Suppl. 2. P. 8 - 11.

[12] Agnelii G., Bergqvist D., Cohen A. et al. Randomized double-blind study to compare the efficacy and safety of postoperative fondaparinux (Arixtra) and preoperative dalteparin in the prevention of venous thromboembolism after high risk abdominal surgery: the PEGASUS Study (abstract) // Blood. 2003. V. 102. P. 15 - 18.

[13] Connoly G.C., Khorana A.A. Emerging risk stratification approaches to cancer-associated thrombosis: risk factors, biomarkers and a risk score // Thrombosis Res. 2010. V. 125. Suppl. 2. P. 1 ? 8.

[14] Bloom J.W., Vanderschoot J.P., Oostindier M.J. et al. Incidence of venous thrombosis in a large cohort of 66329 cancer patients: results of a record linkage study // J. Thromb. Haemost. 2006. V. 4. P. 529 ? 535.

[15] Becker R.C., Fintel D.J., Green D. Antithrombotic therapy. 2th ed. USA. 2002. 352 p.

[16] Hirsh J., Warkentin T.E., Shaughnessy S.G. et al. Heparin and low molecular weight heparin: mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy and safety // Chest. 2001. V. 119. Suppl. 1. P. 64 - 94.

[17] Hirsh J., Anand S.S., Halperin J.L., Fuster V. Guide to Anticoagulant therapy: Heparin. A Statement for healthcare Professionals from the American Heart Association // Curculation. 2001. P. 2994 - 3018.

[18] Mismetti P., Laporte S., Darmon J.Y. et al. Meta-analysis of low-molecular- weight heparin in the prevention pf venous thromboembolism in general surgery // Br. J. Surg. 2001. V. 88. P. 913 - 930.

[19] Martinez-Gonzalez J., Vila L., Rodriguez C. Bemiparin: second-generation, low molecular weight heparin for treatment and prophylaxis of venous thromboembolism // Expert. Rev. Cardiovasc. Ther. 2008. V. 6. № 6. P. 793 - 802.

[20] Morita S., Gebska M.A., Kakkar A.K., Scully M.F. High affinity binding sites for heparin generated on leukocytes during apoptosis arise from nuclear structures segregated during cell death // Blood. 2002. V. 99. P. 2221 - 2227.

[21] Balibrea J.L., Altimiras J., Larruzea I. et al. Optimal dosing of bemiparin as prophylaxis against venous thromboembolism in surgery for cancer: an audit of practice // Int. J. Surg. 2007. V. 5. № 2. P. 114 - 119.

[22] Kakkar W., Howes J., Sharma V., Kadziola Z. A comparative, double-blind, randomizied trial of a new-second generation LMWH (Bemiparin) and UFH in the prevention of post-operative venous thromboembolism in patients undergoing hip arthroplasty // Thromb. Haemost. 2000. V. 83. P. 523 - 529.

[23] Navarro-Quilis A., Castellet E., Rocha E., Paz-Jimenez J., Planes A. Efficasy and safety of bemiparin compared with enoxaparin in the prevention of venous thromboembolism after total knee arthroplasty. A randomized double-blind clinical trial // Thromb. Haemost. 2003. V. 1. P. 425 ? 432.

[24] Rodriguez-Manas L., Gomez-Huelgas R., Veiga-Fernandez F., Ruiz G.M, Gonzalez J.M. Thromboprophylaxis with the low -molecular - weight heparin bemiparin sodium in elderly medical patients in usual clinical practice: the ANCIANOS study // Clin. Drug Investig. 2010. V. 30. № 5. P. 337 - 345.

[25] Monreal B.M., Vignoli A., Lecumberri V.R. et al. Bemiparin in oncology // Drugs. 2010. V. 70. Suppl. 2. P. 35 - 42.

[26] ABEL trial: A phase II randomized trial adding bemiparin to chemo-radiotherapy in limited- stage small cell lung cancer (SCLC) - Final results. 2912. ASCO Annual Meeting. Abstr. 7095. // J. Clin. Oncol. 2012. P. 30.

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