Arguments against Monitoring Levels of Anti-Factor Xa in Conjunction with Low-Molecular-Weight Heparin Therapy

Authors

  • David Rosenbloom Hamilton Health Sciences, McMaster University
  • Jeffrey S. Ginsberg Hamilton Health Sciences, McMaster University

DOI:

https://doi.org/10.4212/cjhp.v55i1.533

Keywords:

anti-factor Xa, low-molecular-weight heparin, monitoring, anti-facteur Xa, héparine de faible poids moléculaire, surveillance

Abstract

ABSTRACT The product monographs for some low-molecular-weight heparins (LMWHs) state that anti-factor Xa concentrations should be monitored in the treatment of deep vein thrombosis. This article reviews the pharmacological and epidemiological basis for this recommendation and finds the evidence wanting. Anti-factor Xa activity varies for each LMWH, and evidence from clinical trials using anti-factor Xa monitoring does not support a link between activity of anti-factor Xa, bleeding, and effect of the drug. Given this lack of evidence, routine monitoring of anti-factor Xa in conjunction with LMWH therapy is not recommended.

RÉSUMÉ Les monographies de produit de certaines héparines de faible poids moléculaire (HFPM) indiquent que les concentrations de l’anti-facteur Xa doivent être surveillées dans le traitement de la thrombose veineuse profonde. Cet article analyse les fondements pharmacologiques et épidémiologiques de cette recommandation et trouve les données insuffisantes. L’activité de l’antifacteur Xa varie pour chaque HFPM et les données tirées des essais cliniques qui ont eu recours à la mesure de l’anti-facteur Xa n’ont pu établir aucun lien entre l’activité de l’anti-facteur Xa, le saignement et l’effet du médicament. Compte tenu des données insuffisantes, il n’est pas recommandé d’effectuer la surveillance systématique de l’anti-facteur Xa dans le cadre d’un traitement à l’héparine de faible poids moléculaire.

Downloads

Download data is not yet available.

Downloads

Issue

Vol. 55 No. 1 (2002)

Section

Articles

License

Copyright © Canadian Society of Healthcare-Systems Pharmacy.

After publication of a manuscript in the CJHP, the authors of the manuscript must obtain written permission from the CSHP (publications@cshp.ca) before reproducing any text, figures, tables, or illustrations from the work in future works of their own. If a submitted manuscript is declined for publication in the CJHP, all said rights shall revert to the authors. Please note that any forms (e.g., preprinted orders and patient intake forms) used by a specific hospital or other health care facility and included as illustrative material with a manuscript are exempt from this copyright transfer. The CJHP will require a letter from the hospital or health care facility granting permission to publish the document(s).