#fondaparinux

(via Low Molecular Weight Heparins (LMWH) - Dalteparin, Enoxaparin, Fondaparinux & Tinzaparin)

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Low-molecular-weight heparins are effective and safe to motivate their use for prevention of post-operative venous thromboembolism (VTE), and they are probably the dominating pharmacological principle in this respect (Geerts et al 2002). In the very beginning of the low-molecular-weight heparin era it was considered important to have a high factor Xa inhibitor activity which ideally should be higher than the IIa inhibitor activity, but over the years the discussion came to focus on the optimal balance between inhibiting factor Xa and factor IIa. It was therefore of great theoretical interest when selective Xa inhibitors were identified, because it was then possible to answer the question: is it possible to obtain a good prophylactic effect by focusing on just one of the factors in the coagulation system? The discussion alluded to above on the role of Xa inhibition in the infancy of low-molecular-weight heparins could thereby be further argumued. The aim of this paper is to summarize present-day knowledge on the prophylactic effect of fondaparinux, a purely synthetic selective indirect inhibitor of factor Xa, the first representative of a new class of antithrombotic substances (Cheng 2002; Hoppensteadt et al 2003; Nijkeuter and Huisman 2004).

Only another case series of three patients11 was published suggesting that the diagnosis of HIT in COVID-19 patients could be underestimated. Clinicians must be aware of the possibility of HIT in patients with COVID-19 treated with UFH or LMWH since early diagnosis is crucial to properly treat this condition while a delayed recognition may contribute to poor outcomes.

Although they are effective, all of this drugs have their limitations and adverse affects. The synthetic pentasaccharide fondaparinux, a subcutaneously administered indirect acting factor-Xa inhibitor, offers a new alternative for both prevention and treatment of HIT, especially where licensed drugs are not available. Here we report the successful use of fondaparinux in the treatment of a patient presenting with acuteon-chronic renal failure requiring hemodialysis and HIT associated with thrombosis (HITT). We also review the current role of fondaparinux in the treatment and prophylaxis of thrombosis in patients with HIT.

Fondaparinux is a synthetic factor Xa inhibitor based on the active site pentasaccharide of heparin. Based on 5 randomized double-blind trials, fondaparinux became the first synthetic factor Xa inhibitor to be approved for clinical use by the Food and Drug Administration specifically for thromboprophylaxis after orthopedic surgery.1–5 More recently, a number of studies have assessed its efficacy in nonorthopedic surgical and medical patients. Fondaparinux has been shown to be equally as effective and safe as dalteparin in high-risk patients undergoing abdominal surgery.6 In acutely ill medical patients, fondaparinux has daparinux slightly elevated the prothrombin time (PT) by 1 second and activated partial thromboplastin time (aPTT) by 5 to 6 seconds, using a single reagent–instrument combination.20 A recent study examined the effects of fondaparinux and direct thrombin inhibitors on coagulation testing. Using mostly Dade Behring reagents, the study found that fondaparinux affected protein S activity resulting in false elevations of protein S levels even at very low (0.2 g/mL) drug concentrations.21 Fondaparinux did not affect fibrinogen, protein C, antithrombin, plasminogen, von Willebrand factor, D-dimer, or factors II, IX, or X. To further assess the influence of fondaparinux on coagulation testing across a wide variety of reagents being used in the United States, we report the results of a College of Pathologists (CAP) proficiency test survey in which the laboratories were asked to perform PT, aPTT, fibrinogen, antithrombin, factor VIII, thrombin time, and anti– factor Xa assays in samples supplemented with different levels of fondaparinux.

Fondaparinux is a medicine that will help your blood flow more easily. It can be used to treat blood clots and to prevent them from forming. This drug is sometimes called a blood thinner.