Absence of placental transfer of pentasaccharide (Fondaparinux, Arixtra) in the dually perfused human cotyledon in vitro.

The synthetic pentasaccharide, fondaparinux, is the first of a new antithrombotic class: selective factor Xa inhibitors. Comparative clinical trials of fondaparinux versus heparins in prevention and treatment of venous thromboembolism are ongoing. Little is known about fondaparinux during pregnancy, as women of child-bearing potential were excluded from clinical trials. No particular safety issue, for either mother or fetus, has been reported for heparins. The objective of this study was to compare in vitro the steady state placental transfer of fondaparinux and enoxaparin at the plasma concentrations reached during acute treatment of venous thromboembolism (1.75 microg/mL and 1 anti-Xa IU/mL respectively), using antipyrine (20 mg/L) as reference. No biological activity was detectable in the fetal venous effluent during perfusion of enoxaparin-antipyrine, fondaparinux-antipyrine or control media. Furthermore, fetal venous samples did not differ significantly from fetal arterial samples. This apparent absence of placental transfer supports further evaluation of fondaparinux in pregnant women.

Rapid and sensitive determination of zidovudine and zidovudine glucuronide in human plasma by ion-pair high-performance liquid chromatography.

A rapid, simple and sensitive method is described for the simultaneous determination in human plasma of the well known antiviral agent zidovudine (AZT) and its main metabolite, zidovudine-5'-O-glucuronide (G-AZT), using a solid-phase extraction method for sample preparation and a rapid ion-pair HPLC separation method with diode-array ultraviolet detection. The method overcomes the problems experienced in other procedures because of the large difference in polarity of the two compounds and the pH-sensitive retention of G-AZT by using n-octylamine to increase the retention of the glucuronide and improve the overall chromatographic behaviour. AZT and G-AZT are eluted at 3.6 and 5 min, respectively, with 7-ethyltheophylline used as internal standard eluting at 4.2 min. Caffeine, a good marker for the elution of related compounds present in plasma, appears well before, at 2.6 min. Quantification limits were established at 0.025 and 0.050 micrograms/ml for AZT and G-AZT, respectively. The improvement in method reproducibility due to the late elution of G-AZT could be observed even at the quantification limit at which an inter-assay relative standard deviation of only 6.4% was found after 3 months of routine use of the method.