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Subcutaneous Enoxaparin Once or Twice Daily Compared with Intravenous Unfractionated Heparin for Treatment of Venous Thromboembolic Disease

Geno Merli, MD; Theodore E. Spiro, MD; Carl-Gustav Olsson, MD, PhD; Ulrich Abildgaard, MD, PhD; Bruce L. Davidson, MD, MPH; Amiram Eldor, MD; Darlene Elias, MD; Andrew Grigg, MBBS; Dominique Musset, MD; George M. Rodgers, MD, PhD; Arthur A. Trowbridge, MD; Roger D. Yusen, MD; Krystyna Zawilska, MD, Enoxaparin Clinical Trial Group*
[+] Article and Author Information

From Thomas Jefferson University, Philadelphia, Pennsylvania; Aventis Pharma SA, Antony, and Hôpital Antoine Béclère, Clamart, France; Aker Hospital, Oslo, Norway; Virginia Mason Medical Center, Seattle, Washington; Institute of Hematology, Tel Aviv, Israel; Scripps Clinic and Research Foundation, La Jolla, California; Royal Melbourne Hospital, Victoria, Australia; University Hospital of Lund, Lund, Sweden; University of Utah Medical Center, Salt Lake City, Utah; Texas A&M University, Temple, Texas; Washington University School of Medicine, Saint Louis, Missouri; and Academy of Medicine, Poznan, Poland.


Grant Support: By Aventis Pharmaceuticals, Inc., Bridgewater, New Jersey, and Aventis Pharma SA, Antony, France (formerly known as Rhône-Poulenc Rorer Pharmaceuticals, Inc., Collegeville, Pennsylvania, and Rhône-Poulenc Rorer SA, Antony, France).

Requests for Single Reprints: Theodore E. Spiro, MD, Aventis Pharma SA, Cardiovascular Therapeutic Area, 20 Avenue Raymond Aron, 92165 Antony Cedex, France; e-mail, theodore.spiro@aventis.com.

Current Author Addresses: Dr. Merli: Division of Internal Medicine, Thomas Jefferson University, 3rd Floor, 211 South Ninth Street, Philadelphia, PA 19107.

Dr. Spiro: Cardiovascular Therapeutic Area, Aventis Pharma SA, 20 Avenue Raymond Aron, 92165 Antony Cedex, France.

Dr. Olsson: Medical Department, University Hospital of Lund, S 22185 Lund, Sweden.

Dr. Abildgaard: Medical Department, Aker Hospital, 0514 Oslo, Norway.

Dr. Davidson: Pulmonary and Critical Care, Virginia Mason Medical Center, C7-PUL, 1100 Ninth Avenue, Seattle, WA 98101.

Dr. Eldor: Institute of Hematology, Tel-Aviv Souraski Medical Center, Tel Aviv 63409, Israel.

Dr. Elias: Chest and Critical Care Medicine, Scripps Clinic and Research Foundation, 10666 North Torrey Pines Road, Mailstop 207 W, La Jolla, CA 92037.

Dr. Grigg: Department of Haematology, Royal Melbourne Hospital, Grattan Street, Victoria 3052, Australia.

Dr. Musset: Hôpital Antoine Béclère. 157 rue de la Porte de Trivaux, 92140 Clamart, France.

Dr. Rodgers: Hematology-Oncology Division, University of Utah Medical Center, 50 North Medical Drive, Salt Lake City, UT 84132.

Dr. Trowbridge: Division of Hematology/Oncology, Scott and White Clinic, Texas A&M University, College of Medicine, 2401 South 31st Street, Temple, TX 76508.

Dr. Yusen: Divisions of Pulmonary and Critical Care Medicine and General Medical Sciences, Washington University School of Medicine, Campus Box 8052, Barnes-Jewish Hospital, 660 South Euclid Avenue, Saint Louis, MO 63110-1093.

Dr. Zawilska: Department of Haematology, Academy of Medicine, Ul. Szkolna 8/12, 61-833 Poznan, Poland.

Author Contributions: Conception and design: G. Merli, T.E. Spiro, C.-G. Olsson, U. Abildgaard, B.L. Davidson, A.A. Trowbridge.

Analysis and interpretation of the data: G. Merli, T.E. Spiro, C.-G. Olsson, U. Abildgaard, B.L. Davidson, A. Eldor, D. Elias, A. Grigg, D. Musset, G.M. Rodgers, R.D. Yusen.

Drafting of the article: G. Merli, T.E. Spiro, C.-G. Olsson, U. Abildgaard, B.L. Davidson, A. Eldor, D. Elias, G.M. Rodgers, A.A. Trowbridge, R.D. Yusen.

Critical revision of the article for important intellectual content: G. Merli, T.E. Spiro, C.-G. Olsson, U. Abildgaard, B.L. Davidson, A. Eldor, D. Elias, A. Grigg, D. Musset, G.M. Rodgers, A.A. Trowbridge, R.D. Yusen, K. Zawilska.

Final approval of the article: G. Merli, T.E. Spiro, C.-G. Olsson, B.L. Davidson, A. Eldor, A. Grigg, A.A. Trowbridge, R.D. Yusen, K. Zawilska.

Provision of study materials or patients: T.E. Spiro, C.-G. Olsson, U. Abildgaard, B.L. Davidson, A. Eldor, D. Elias, A. Grigg, D. Musset, G.M. Rodgers, A.A. Trowbridge, R.D. Yusen, K. Zawilska.

Statistical expertise: T.E. Spiro, B.L. Davidson, R.D. Yusen.

Obtaining of funding: T.E. Spiro.

Administrative, technical, or logistic support: T.E. Spiro.

Collection and assembly of data: T.E. Spiro, B.L. Davidson, A.A. Trowbridge, R.D. Yusen.


Ann Intern Med. 2001;134(3):191-202. doi:10.7326/0003-4819-134-3-200102060-00009
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Venous thromboembolic disease causes significant morbidity and mortality in both hospitalized and nonhospitalized patients. The mean annual incidence in the United States is 48 per 100 000 for deep venous thrombosis and 23 per 100 000 for pulmonary embolism, according to an epidemiologic study conducted in Massachusetts (1). A similar study in Sweden showed an annual incidence of 160 new cases of deep venous thrombosis per 100 000 inhabitants (2).

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Grahic Jump Location
Figure.
Product-limit analysis of time to first recurrence of a venous thromboembolic event among all treated patients.

Dotted line represents twice-daily enoxaparin; solid line represents unfractionated heparin; dashed line represents once-daily enoxaparin.

Grahic Jump Location

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Summary for Patients

Comparison of Two Forms of the Anticlotting Drug Heparin for Treatment of Blood Clots in the Legs

The summary below is from the full report titled “Subcutaneous Enoxaparin Once or Twice Daily Compared with Intravenous Unfractionated Heparin for Treatment of Venous Thromboembolic Disease.” It is in the 6 February 2001 issue of Annals of Internal Medicine (volume 134, pages 191-202). The authors are G Merli, TE Spiro, C-G Olsson, U Abildgaard, BL Davidson, A Eldor, D Elias, A Grigg, D Musset, GM Rodgers, AA Trowbridge, RD Yusen, and K Zawilska, for the Enoxaparin Clinical Trial Group.

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