[Parnaparin sodium - modern therapy options and prevention of venous thromboembolic complications]. / Parnaparin natriya ­ sovremennye vozmozhnosti terapii i profilaktiki venoznykh tromboembolicheskikh oslozhnenii.

Venous thromboembolic complications (VTEC) including pulmonary embolism and acute thrombosis of deep and superficial veins of the lower extremities are often observed in postoperative period. Low-molecular-weight heparin (LMWH) is a common remedy for prevention and treatment of VTEC due to high efficiency, safety, easy use and dosage. According to the modern literature data, LMWH is characterized by different effectiveness in relation to VTEC and risk of bleeding in patients after surgical and traumatological procedures, as well as in ones with severe forms of chronic venous diseases. However, their antithrombin activity varies significantly depending on mean molecular weight. The authors analyze LMWH action mechanism, pharmacokinetic and pharmacodynamic features of LMWH, in particular parnaparin sodium. Efficacy, safety and tolerability of this remedy for various forms of VTEC (superficial and deep vein thrombosis, thrombophlebitis, complicated forms of chronic venous diseases), its advantages for prevention of VTEC after various surgical and orthopedic interventions are considered.

[Sulodexide in treatment of chronic venous insufficiency. Results of the All-Russian multicenter programme ACVEDUCT]. / Sulodeksid v lechenii khronicheskoi venoznoi nedostatochnosti. Itogi Vserossiiskoi mul'titsentrovoi programmy ACVEDUCT.

INTRODUCTION: Pharmacotherapy occupies one of the leading places in comprehensive treatment of lower-limb chronic venous diseases (CVD) and their complications. At the same time, there are not so many therapeutic agents intended for treatment of CVD and possessing evidence-based efficacy. Sulodexide (registered in Russia as Vessel Due F) is a drug with a confirmed therapeutic effect in patients with a moderately severe course of chronic venous disease or its late stages. However, the experience of using it in Russia for treatment of patients presenting with initial manifestations of chronic venous insufficiency (CVI) is still scarce. PATIENTS AND METHODS: The data concerning the use of Vessel Due F in the routine practice of treating CVD in Russian patients were collected and assessed within the framework of the ACVEDUCT programme. This observational prospective non-controlled multicentre programme included patients routinely prescribed by their attending physician Vessel Due F as a solution for injections and/or soft capsules in accordance with the registered in the Russian Federation instruction for use. A total of 2,263 patients took part in the programme. RESULTS: The majority of the patients prescribed sulodexide were diagnosed as having CEAP class C3 (38.4%) and class C4 (35.6%) CVD. Treatment was accompanied and followed by a decrease in the symptoms' severity observed in 56.4% of patients and a decrease in the number of symptoms in 42.8% of patients (thus positive dynamics was totally noted in 99.2%), with the effect of taking the drug commencing to manifest itself in patients as early as on day 15-20 of treatment. The highest rate of regression of symptoms of CVD was observed in 30-to-40-year-old patients. A statistically significant positive correlation was revealed between efficacy and the duration of treatment, the use of capsules during the term of follow up, with a negative correlation revealed between efficacy of treatment and the patient's age at which the diagnosis had been made, the stage according the CEAP classification, the total number of symptoms, a combination of risk factors. CONCLUSIONS: Sulodexide proved to be an effective, safe, well-tolerated and pathogenetically substantiated pharmacological agent for treatment of patients presenting with lower-limb CVI and should therefore be recommended for patients at early stages of formation of CVD. Patients suffering from venous trophic ulcers require higher doses and prolonged administration of the drug.

[Use of a thrombin inhibitor for treatment of deep vein thrombosis and pulmonary thromboembolism in patients with thrombophilia]. / Primenenie ingibitora trombina dlia lecheniia tromboza glubokikh ven i tromboémbolii legochnoi arterii u bol'nykh s trombofiliei.

Presented herein are the results of oral administration of dabigatran etexilate for treatment and secondary prevention of lower-limb deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) in patients with established thrombophilia, studying its efficacy and safety in prolonged administration during a year as compared with warfarin. The study group included a total of fifty-seven 18-to-79-year-old patients (33 men and 24 women) with DVT and PTE, taking dabigatran etexilate. The comparison group was composed of a total of 126 patients (65 men and 61 women) with DVT and PTE, taking warfarin. Efficacy of the drugs was analysed in relation to the development of relapses thromboembolic complications, with the drugs' safety profile being evaluated in relation to the development of major and clinically significant haemorrhage. It was determined that prolonged administration of dabigatran etexilate taken at a fixed dose (150 mg twice daily) for 6-12 months in patients with DVT and PTE and with confirmed thrombophilia turned out to be effective for secondary prevention of relapsing venous thromboembolic complications and lethal outcomes, indirectly contributing to recanalization of the lower-limb venous bed, with the drug possessing a favourable profile of safety concerning the development of haemorrhagic complications as compared with warfarin and requiring no routine laboratory monitoring.

[Use of dabigatran etexilate for treatment of deep vein thrombosis and pulmonary artery thromboembolism].

The authors present herein their experience in oral administration of dabigatran etexilate for treatment of lower-limb deep vein thrombosis and pulmonary thromboembolism in patients with thrombophilia, as well as assessment of its efficacy and safety. The study included a total of nineteen 20-to-79-year-old patients (11 men and 8 women) with venous thromboembolic complications. An inclusion criterion was the presence of lower-limb deep vein thrombosis documented in the B-mode in ultrasonography alone or in a combination with pulmonary thromboembolism confirmed by angiopulmonography end echocardiography. The exclusion criteria were as follow: oncological diseases, a history of surgical interventions, acute infections, skeletal injuries and fractures, long-term immobilization, age under 20 and over 79 years. For 6 months the authors evaluated patients' tolerance of dabigatran, its efficacy, as well as the profile of safety concerning the development of major and clinically significant haemorrhage. It was determined that administration of dabigatran in patients with confirmed thrombophilia at a fixed dose (150 mg twice daily) during 6 months for treatment of lower-limb venous thromboses and pulmonary thromboembolism turned out to be effective and safe, with the drug possessing a good profile of safety and its administration requiring no routine laboratory monitoring.