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Once‑daily vs. twice‑daily dosing of enoxaparin for the management of venous thromboembolism: A systematic review and meta‑analysis

  • Authors:
    • Jingrong Niu
    • Yixiao Song
    • Chunmin Li
    • Hualiang Ren
    • Wangde Zhang
  • View Affiliations / Copyright

    Affiliations: Department of Vascular Surgery, Beijing Chao‑Yang Hospital, Capital Medical University, Beijing 100020, P.R. China, School of Life Science, Tsinghua University, Beijing 100084, P.R. China
    Copyright: © Niu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 3084-3095
    |
    Published online on: July 24, 2020
       https://doi.org/10.3892/etm.2020.9036
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Abstract

The present study aimed to determine whether there is any difference in the efficacy and safety of once‑daily vs. twice‑daily enoxaparin when used for the initial treatment of venous thromboembolism (VTE). The PubMed, Embase, Cochrane Central Register of Controlled Trials, Science Direct and Google Scholar databases were searched for studies comparing once‑daily and twice‑daily enoxaparin for the initial treatment of VTE added from inception up to 1st October 2019. Studies utilizing any other low‑molecular‑weight heparin and using enoxaparin for VTE prophylaxis were excluded. A total of 6 studies were included in the systematic review and 5 in the meta‑analysis. Only one study was a randomized controlled trial (RCT). Pooled analysis of 460 patients receiving once‑daily enoxaparin and 464 patients receiving twice‑daily enoxaparin indicated no significant difference between the two dosing regimens regarding VTE recurrence [odds ratio (OR)=1.48, 95%CI: 0.75‑2.89, P=0.26; I2=0%]. No significant difference in major hemorrhagic complications was noted (OR=1.21, 95%CI: 0.52‑2.81, P=0.66; I2=0%). Sub‑group analysis based on study type and use of enoxaparin for bridging therapy did not change the overall results. In cancer patients, no statistically significant difference in the recurrence of VTE was obtained between once‑daily and twice‑daily enoxaparin, but the confidence intervals were wide with a tendency to favor twice‑daily dosing (OR=2.28, 95%CI: 0.91‑5.75, P=0.08; I2=0%). The overall quality of the studies was determined to be average. To conclude, while the present results suggested no significant difference in efficacy and safety of once‑daily vs. twice‑daily enoxaparin when used for the initial treatment of VTE, the quality of the evidence may not have been sufficiently high to support the conclusions with confidence. Further high‑quality and adequately powered RCTs are required to corroborate the present results.
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1 

Tagalakis V, Patenaude V, Kahn SR and Suissa S: Incidence of and mortality from venous thromboembolism in a Real-world population: The Q-VTE study cohort. Am J Med. 126:832.e13–e21. 2013.PubMed/NCBI View Article : Google Scholar

2 

Spencer FA, Emery C, Lessard D, Anderson F, Emani S, Aragam J, Becker RC and Goldberg RJ: The worcester venous thromboembolism study: A population-based study of the clinical epidemiology of venous thromboembolism. J Gen Intern Med. 21:722–727. 2006.PubMed/NCBI View Article : Google Scholar

3 

Huang W, Goldberg RJ, Cohen AT, Anderson FA, Kiefe CI, Gore JM and Spencer FA: Declining Long-term risk of adverse events after First-time Community-presenting venous thromboembolism: The Population-based Worcester VTE study (1999 to 2009). Thromb Res. 135:1100–1106. 2015.PubMed/NCBI View Article : Google Scholar

4 

Hirsh J and Levine MN: Low molecular weight heparin. Blood. 79:1–17. 1992.PubMed/NCBI

5 

Robertson L and Jones LE: Fixed dose subcutaneous low molecular weight heparins versus adjusted dose unfractionated heparin for the initial treatment of venous thromboembolism. Cochrane Database Syst Rev. 2(CD001100)2017.PubMed/NCBI View Article : Google Scholar

6 

Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, Huisman M, King CS, Morris TA, Sood N, et al: Antithrombotic therapy for VTE disease: CHEST Guideline and expert panel report. Chest. 149:315–352. 2016.PubMed/NCBI View Article : Google Scholar

7 

Lindmarker P, Holmström M, Granqvist S, Johnsson H and Lockner D: Comparison of once-daily subcutaneous Fragmin with continuous intravenous unfractionated heparin in the treatment of deep vein thrombosis. Thromb Haemost. 72:186–90. 1994.PubMed/NCBI

8 

Collignon F, Frydman A, Caplain H, Ozoux ML, Le Roux Y, Bouthier J and Thébault JJ: Comparison of the pharmacokinetic profiles of three low molecular mass heparins-dalteparin, enoxaparin and nadroparin-administered subcutaneously in healthy volunteers (doses for prevention of thromboembolism). Thromb Haemost. 73:630–40. 1995.PubMed/NCBI

9 

Fuller K, Malecki S, Anselmo L, Borrego ME, Jakeman B and Burnett A: Once-daily versus Twice-daily enoxaparin for the treatment of acute venous thromboembolism in cancer patients. Ann Pharmacother. 52:257–262. 2018.PubMed/NCBI View Article : Google Scholar

10 

Yusuf M, Gouda M, Herz-Allah A, Alkhouly M and Samir A: Once-daily versus twice-daily enoxaparin for the initial treatment of acute deep venous thrombosis: A case-control study. J Med Sci Res. 2:144–147. 2019.

11 

Bhutia S and Wong PF: Once versus twice daily low molecular weight heparin for the initial treatment of venous thromboembolism. Cochrane Database Syst Rev. 2013(CD003074)2013.PubMed/NCBI View Article : Google Scholar

12 

Moher D, Liberati A, Tetzlaff J, Altman DG and PRISMA Group: Preferred reporting items for systematic reviews and Meta-analyses: The PRISMA statement. PLoS Med. 6(e1000097)2009.PubMed/NCBI View Article : Google Scholar

13 

Higgins JPT and Green S (eds): Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011.

14 

Higgins J, Altman D and Sterne J: Cochrane statistical methods group and the cochrane bias methods group. Chapter 8: Assessing risk of bias in included studies. In: Cochrane handbook for systemic reviews of interventions, version 5. The Cochrane Collaboration, 2011.

15 

Kim SY, Park JE, Lee YJ, Seo HJ, Sheen SS, Hahn S, Jang BH and Son HJ: Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity. J Clin Epidemiol. 66:408–414. 2013.PubMed/NCBI View Article : Google Scholar

16 

Partsch H, Kechavarz B, Mostbeck A, Köhn H and Lipp C: Frequency of pulmonary embolism in patients who have iliofemoral deep vein thrombosis and are treated with once- or twice-daily low-molecular-weight heparin. J Vasc Surg. 24:774–82. 1996.PubMed/NCBI View Article : Google Scholar

17 

Siegbahn A, Y-Hassan S, Boberg J, Bylund H, Neerstrand HS, Ostergaard P and Hedner U: Subcutaneous treatment of deep venous thrombosis with low molecular weight heparin. A dose finding study with LMWH-Novo. Thromb Res. 55:767–78. 1989.PubMed/NCBI View Article : Google Scholar

18 

Holmoström M, Berglund MC, Granquist S, Bratt G, Törnebohm E and Lockner D: Fragmin once or twice daily subcutaneously in the treatment of deep venous thrombosis of the leg. Thromb Res. 67:49–55. 1992.PubMed/NCBI View Article : Google Scholar

19 

Charbonnier BA, Fiessinger JN, Banga JD, Wenzel E, d'Azemar P and Sagnard L: Comparison of a once daily with a twice daily subcutaneous low molecular weight heparin regimen in the treatment of deep vein thrombosis. FRAXODI group. Thromb Haemost. 79:897–901. 1998.PubMed/NCBI

20 

Narin C, Reyhanoglu H, Tülek B, Onoglu R, Ege E, Sarigül A, Yeniterzi M and Durmaz I: Comparison of different dose regimens of enoxaparin in deep vein thrombosis therapy in pregnancy. Adv Ther. 25:585–594. 2008.PubMed/NCBI View Article : Google Scholar

21 

Trujillo-Santos J, Bergmann JF, Bortoluzzi C, López-Reyes R, Giorgi-Pierfranceschi M, López-Sáez JB, Ferrazzi P, Bascuñana J, Suriñach JM and Monreal M: Once versus twice daily enoxaparin for the initial treatment of acute venous thromboembolism. J Thromb Haemost. 15:429–438. 2017.PubMed/NCBI View Article : Google Scholar

22 

Merli G, Spiro TE, Olsson CG, Abildgaard U, Davidson BL, Eldor A, Elias D, Grigg A, Musset D, Rodgers GM, et al: Subcutaneous enoxaparin once or twice daily compared with intravenous unfractionated heparin for treatment venous thromboembolic disease. Ann Intern Med. 134:191–202. 2001.PubMed/NCBI View Article : Google Scholar

23 

Merli H, Shetty R, Niles CM, Gerhard-Herman M, Vallurupalli N, Baroletti S, McKean SC, Sonis J, Parasuraman S, Kosowsky JM and Goldhaber SZ: Once daily enoxaparin for outpatient treatment of acute venous thromboembolism: A case-control study. Clin Appl Thromb. 16:21–25. 2010.PubMed/NCBI View Article : Google Scholar

24 

King AC, Ma MQ, Chisholm G and Toale KM: Once daily versus twice daily enoxaparin for acute pulmonary embolism in cancer patients. J Oncol Pharm Pract. 22:265–270. 2016.PubMed/NCBI View Article : Google Scholar

25 

Tazi Mezalek Z, Nejjari C, Essadouni L, Samkaoui M, Serraj K, Ammouri W, Kanjaa N, Belkhadir Z, Housni B, Awab M, et al: Evaluation and management of thromboprophylaxis in Moroccan hospitals at national level: The Avail-MoNa study. J Thromb Thrombolysis. 46:113–119. 2018.PubMed/NCBI View Article : Google Scholar

26 

Merli GJ and Groce JB: Pharmacological and clinical differences between low-molecular-weight heparins: Implications for prescribing practice and therapeutic interchange. P T. 35:95–105. 2010.PubMed/NCBI

27 

Diaz AH, Rodgers GM and Gilreath JA: Enoxaparin once daily vs. twice daily dosing for the treatment of venous thromboembolism in cancer patients: A literature summary. J Oncol Pharm Pract. 18:264–70. 2012.PubMed/NCBI View Article : Google Scholar

28 

Levine M, Gent M, Hirsh J, Leclerc J, Anderson D, Weitz J, Ginsberg J, Turpie AG, Demers C and Kovacs M: A comparison of low-molecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis. N Engl J Med. 334:677–681. 1996.PubMed/NCBI View Article : Google Scholar

29 

Hutten BA, Prins MH, Gent M, Ginsberg J, Tijssen JG and Büller HR: Incidence of recurrent thromboembolic and bleeding complications among patients with venous thromboembolism in relation to both malignancy and achieved international normalized ratio: A retrospective analysis. J Clin Oncol. 18:3078–3083. 2000.PubMed/NCBI View Article : Google Scholar

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Copy and paste a formatted citation
Spandidos Publications style
Niu J, Song Y, Li C, Ren H and Zhang W: Once‑daily vs. twice‑daily dosing of enoxaparin for the management of venous thromboembolism: A systematic review and meta‑analysis. Exp Ther Med 20: 3084-3095, 2020.
APA
Niu, J., Song, Y., Li, C., Ren, H., & Zhang, W. (2020). Once‑daily vs. twice‑daily dosing of enoxaparin for the management of venous thromboembolism: A systematic review and meta‑analysis. Experimental and Therapeutic Medicine, 20, 3084-3095. https://doi.org/10.3892/etm.2020.9036
MLA
Niu, J., Song, Y., Li, C., Ren, H., Zhang, W."Once‑daily vs. twice‑daily dosing of enoxaparin for the management of venous thromboembolism: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 20.4 (2020): 3084-3095.
Chicago
Niu, J., Song, Y., Li, C., Ren, H., Zhang, W."Once‑daily vs. twice‑daily dosing of enoxaparin for the management of venous thromboembolism: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 20, no. 4 (2020): 3084-3095. https://doi.org/10.3892/etm.2020.9036
Copy and paste a formatted citation
x
Spandidos Publications style
Niu J, Song Y, Li C, Ren H and Zhang W: Once‑daily vs. twice‑daily dosing of enoxaparin for the management of venous thromboembolism: A systematic review and meta‑analysis. Exp Ther Med 20: 3084-3095, 2020.
APA
Niu, J., Song, Y., Li, C., Ren, H., & Zhang, W. (2020). Once‑daily vs. twice‑daily dosing of enoxaparin for the management of venous thromboembolism: A systematic review and meta‑analysis. Experimental and Therapeutic Medicine, 20, 3084-3095. https://doi.org/10.3892/etm.2020.9036
MLA
Niu, J., Song, Y., Li, C., Ren, H., Zhang, W."Once‑daily vs. twice‑daily dosing of enoxaparin for the management of venous thromboembolism: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 20.4 (2020): 3084-3095.
Chicago
Niu, J., Song, Y., Li, C., Ren, H., Zhang, W."Once‑daily vs. twice‑daily dosing of enoxaparin for the management of venous thromboembolism: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 20, no. 4 (2020): 3084-3095. https://doi.org/10.3892/etm.2020.9036
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