Venous Thromboembolism Clinical Trial
Official title:
Retrospektive Studie zu Patientinnen, Die pränatal, Perinatal Oder Postnatal Prophylaktisch Oder Therapeutisch Mit Fondaparinux Behandelt Wurden
The objective of this retrospective study is to gather information about how fondaparinux is used pre-, peri- and/or postpartum for both the prophylaxis and treatment of venous thromboembolism (VTE) in order to fill an information gap concerning the off-label use of fondaparinux during pregnancy.
During pregnancy there is a generally enhanced risk to develop venous thromboembolism (VTE).
Although such events are rare they may lead to serious risks for the mothers´ and children´s
health. Compared with non-pregnant women, pregnant women have an about five-fold risk to
develop VTE.
Due to their characteristic spectrum of side effects and the generally long duration of
exposure in pregnancy the preferred anticoagulants may produce potentially dangerous side
effects, as bleedings, heparin-induced thrombocytopenia (HIT), allergic reactions,
osteoporosis, or congenital anomalies.
Today, low-molecular weight heparins (LMWH) are the preferred agents for anticoagulation in
pregnancy. Compared with unfractioned heparins (UFH) LMWHs have the advantages of a lower
bleeding risk, a lower rate of allergic reactions and HIT, a more predictable response and a
longer half-life that makes dosing more convenient (od or bid).
Still, there is a considerable proportion of pregnancies where heparin intolerance (allergic
reactions or HIT) that make it inevitable to change to another anticoagulant.
On the one hand, fondaparinux has repeatedly been reported successful in the VTE prophylaxis
of pregnancies where allergic reactions on heparins, or heparinoids, had occurred.
Additionally, a considerable amount of oral reports have reached GSK about an additional
number of successful cases in the past.
On the other hand, we have no systematic and overall view about how many pregnancies have
already been treated for which reasons, and how successful they were. Due to an increase of
certain risk factors, as obesity or the growing age of mothers at childbirth with the
associated need for anticoagulation, we expect an increased number of cases where
alternative anticoagulation to heparins may be needed.
There are a number of potential advantages of fondaparinux over heparins, such as a once
daily application, no dose adjustment needed to body weight and no monitoring of
thrombocytes, a lower potential for causing intolerance reactions and no risk for HIT.
The objective of this retrospective study is to gather information about how fondaparinux is
used pre-, peri- and/or postpartum for both the prophylaxis and treatment of VTE in order to
fill an information gap concerning the off-label use of fondaparinux during pregnancy.
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Observational Model: Cohort, Time Perspective: Retrospective
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