Thromboembolism is a blood clot in the blood vessel that breaks loose and is carried by the blood stream to plug another vessel. The clot may plug a vessel in the lungs, causing pulmonary embolism; brain, causing a stroke; gastrointestinal track, kidneys or leg. Thromboembolism is a common complication of cancer and cancer treatments, and is usually treated with blood thinners, such as heparin.

Though a relatively new therapy for the prevention of thromboembolism, low-molecular-weight heparins, such as nadroparin, are as effective as high-molecular-weight heparins. One benefit to low-molecular-weight heparins is that treatment can be started and completed in an outpatient setting, as opposed to high-molecular-weight treatments, which require in-hospital monitoring.

The study involved 1,166 patients with metastatic cancer receiving chemotherapy for cancers involving the lungs, breasts, head and neck, stomach, colon, rectum and pancreas. The incidence of blood clots in patients who received nadroparin was 2.1 percent compared to 3.9 in patients who received a placebo. Higher rates of thrombembolism was present in patients with lung and pancreatic caners. The study also showed a slight (0.7 percent) incidence of major bleeding in patients who received nadroparin compared to 0 percent in the placebo group.

SOURCE: Heparin Recall › Low-molecular-weight heparin good therapy for cancer patients

Dr. Deborah Cook, academic chair of critical care medicine at St. Joseph’s, is leading a study to determine whether the newer and more expensive version of the blood thinner is more effective for patients in intensive care than the older one. Fifty-six ICUs in Canada, Australia, Brazil, U.S. and Saudi Arabia will participate in the study. Patients will be chosen at random from each of the participating ICUs.

The study also will look at each drug’s side effects, which can include excessive or unusual bleeding.

Heparin, which is used to prevent blood clotting, is routinely given to most ICU patients. The newer version has been touted as being stronger and thus is used most often. The newer heparin costs about $9 per day per patient compared to $2 per day per patient for the older version.

The study, which is called PROTECT and stands for Profhylaxis of Thromboembolism in Critical Care Trial, is funded by the Canadian Institutes of Health Research. No results have yet been posted for the study, which is currently halfway through the 2 ½-year research process.

SOURCE: Heparin Recall › Study compares brands of heparin given to ICU patients