[Monitoring of tinzaparin in a ten day treatment dose in elderly patients]. / Surveillance d'un traitement par la tinzaparine à dose curative pendant dix jours chez le sujet âgé.
Rev Med Interne
; 22(2): 120-6, 2001 Feb.
Article
em Fr
| MEDLINE
| ID: mdl-11234669
ABSTRACT
PURPOSE:
Renal impairment, which is frequently observed in elderly patients, raises the question of low molecular weight heparins treatment dose adjustment in this population. Thus, we conducted a prospective study to determine whether tinzaparin, administered subcutaneously at treatment dose (175 anti-Xa IU/kg) once daily for 10 days, does accumulate in patients older than 70 years of age.METHODS:
Accumulation criteria were an increase of plasma anti-Xa and anti-IIa levels determined prior to the first injection and on days 2, 5, 7 and 10. The characteristics of the 30 consecutive included patients receiving tinzaparin at treatment dose (six men, 24 women) were age 87.0 +/- 5.9 years (range 71-96 years), body weight 62.7 +/- 14.6 kg (range 38-90 kg) and creatinine clearance 40.6 +/- 15.3 mL/min (range 20-72 mL/min).RESULTS:
None of the patients required a dose adjustment of tinzaparin over the 10-day treatment period. Anti-Xa and anti-IIa activity levels on day 2 were 0.66 +/- 0.20 IU/mL (range 0.26-1.04 IU/mL) and 0.33 +/- 0.10 IU/mL (range 0.18-0.55 IU/mL), respectively. These levels did not significantly change over the 10 days. These results favor the absence of the accumulation effect of tinzaparin. There was no correlation between anti-Xa and anti-IIa activities and age, weight, or creatinine clearance. Concerning the side-effects, only one minor hematoma at the injection site was reported.CONCLUSION:
Tinzaparin may thus be administered in older patients with renal impairment, at a treatment dose (175 anti-Xa IU/kg/d) for a 10-day treatment period, without accumulation effect nor hemorrhagic side-effect in patients with creatinine clearance greater than 20 mL/min.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
/
Heparina de Baixo Peso Molecular
/
Fibrinolíticos
/
Falência Renal Crônica
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
Fr
Revista:
Rev Med Interne
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
França