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Extended use of anti-clotting drug helps some bedridden patients
Date:7/6/2010

A treatment plan used to prevent potentially dangerous blood clots in recovering surgical patients can also benefit some patients immobilized by acute medical illness, doctors have found in a multi-institutional study.

In women, patients age 75 or older, and patients strictly confined to 24-hour bed rest, a month of extended treatment with a blood thinner significantly reduced the chances of blood clots while only slightly increasing the risk of bleeding.

Researchers at Washington University School of Medicine in St. Louis and several other institutions report the results online this week in Annals of Internal Medicine. The double-blind, placebo-controlled trial was funded by Sanofi-Aventis, the manufacturer of enoxaparin, a form of the blood thinner heparin that was used in the study.

Causes of decreased mobility of patients in the study varied and included heart failure, infections and chronic respiratory disease.

"We currently treat acutely ill medical patients with a week or two of blood thinners to prevent clots," says co-author Roger D. Yusen, MD, associate professor of medicine at Washington University. "These results suggest that, depending on the patient, physicians may want to consider extending that treatment for an additional month."

Extended treatment with a blood thinner is already standard in such contexts as recovery from knee and hip replacement surgery and abdominal cancer surgery.

Yusen is a member of the steering committee for the study, known as the EXCLAIM, or Extended Prophylaxis for Venous ThromboEmbolism (VTE) in Acutely Ill Medical Patients With Prolonged Immobilization trial.

To be eligible for the trial, patients had to be 40 years or older, have had decreased mobility within the three days prior to admission and have been likely to have decreased mobility for at least three more days after admission. Patients were given the conventional six to 14 days of enoxapar
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Contact: Michael C. Purdy
purdym@wustl.edu
314-286-0122
Washington University School of Medicine
Source:Eurekalert

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