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Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery

Background: An outbreak of African swine fever (ASF) in China in 2020 has led to an unprecedented shortage of nadroparin. Most patients, especially those kept in hospital for surgery, are currently treated with prophylactic anticoagulation (AC). In search of alternatives for nadroparin (fraxiparine)...

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Autores principales: Wilhelmy, Florian, Hantsche, Annika, Gaier, Michael, Kasper, Johannes, Fehrenbach, Michael Karl, Oesemann, Rene, Meixensberger, Jürgen, Lindner, Dirk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8162528/
https://www.ncbi.nlm.nih.gov/pubmed/34067998
http://dx.doi.org/10.3390/neurolint13020021
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author Wilhelmy, Florian
Hantsche, Annika
Gaier, Michael
Kasper, Johannes
Fehrenbach, Michael Karl
Oesemann, Rene
Meixensberger, Jürgen
Lindner, Dirk
author_facet Wilhelmy, Florian
Hantsche, Annika
Gaier, Michael
Kasper, Johannes
Fehrenbach, Michael Karl
Oesemann, Rene
Meixensberger, Jürgen
Lindner, Dirk
author_sort Wilhelmy, Florian
collection PubMed
description Background: An outbreak of African swine fever (ASF) in China in 2020 has led to an unprecedented shortage of nadroparin. Most patients, especially those kept in hospital for surgery, are currently treated with prophylactic anticoagulation (AC). In search of alternatives for nadroparin (fraxiparine), we found no sufficient data on alternatives for neurosurgical patients, such as tinzaparin of European origin. We compared nadroparin and tinzaparin concerning adverse events (bleeding versus thromboembolic events) in neurosurgical patients. Methods: Between 2012 and 2018, 517 neurosurgical patients with benign and malignant brain tumors as well as 297 patients with subarachnoid hemorrhage (SAH) were treated in the Department of Neurosurgery, University Hospital Leipzig, receiving prophylactic anticoagulation within 48 h. In 2015, prophylactic anticoagulation was switched from nadroparin to tinzaparin throughout the university hospital. In a retrospective manner, the frequency and occurrence of adverse events (rebleeding and thromboembolic events) in connection with the substance used were analyzed. Statistical analysis was performed using Fisher’s exact test and the chi-squared test. Results: Rebleeding rates were similar in both nadroparin and tinzaparin cohorts in patients being treated for meningioma, glioma, and SAH combined (8.8% vs. 10.3%). Accordingly, the rates of overall thromboembolic events were not significantly different (5.5% vs. 4.3%). The severity of rebleeding did not vary. There was no significant difference among subgroups when compared for deep vein thrombosis (DVT) or pulmonary embolism (PE). Conclusion: In this retrospective study, tinzaparin seems to be a safe alternative to nadroparin for AC in patients undergoing brain tumor surgery or suffering from SAH.
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spelling pubmed-81625282021-05-29 Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery Wilhelmy, Florian Hantsche, Annika Gaier, Michael Kasper, Johannes Fehrenbach, Michael Karl Oesemann, Rene Meixensberger, Jürgen Lindner, Dirk Neurol Int Brief Report Background: An outbreak of African swine fever (ASF) in China in 2020 has led to an unprecedented shortage of nadroparin. Most patients, especially those kept in hospital for surgery, are currently treated with prophylactic anticoagulation (AC). In search of alternatives for nadroparin (fraxiparine), we found no sufficient data on alternatives for neurosurgical patients, such as tinzaparin of European origin. We compared nadroparin and tinzaparin concerning adverse events (bleeding versus thromboembolic events) in neurosurgical patients. Methods: Between 2012 and 2018, 517 neurosurgical patients with benign and malignant brain tumors as well as 297 patients with subarachnoid hemorrhage (SAH) were treated in the Department of Neurosurgery, University Hospital Leipzig, receiving prophylactic anticoagulation within 48 h. In 2015, prophylactic anticoagulation was switched from nadroparin to tinzaparin throughout the university hospital. In a retrospective manner, the frequency and occurrence of adverse events (rebleeding and thromboembolic events) in connection with the substance used were analyzed. Statistical analysis was performed using Fisher’s exact test and the chi-squared test. Results: Rebleeding rates were similar in both nadroparin and tinzaparin cohorts in patients being treated for meningioma, glioma, and SAH combined (8.8% vs. 10.3%). Accordingly, the rates of overall thromboembolic events were not significantly different (5.5% vs. 4.3%). The severity of rebleeding did not vary. There was no significant difference among subgroups when compared for deep vein thrombosis (DVT) or pulmonary embolism (PE). Conclusion: In this retrospective study, tinzaparin seems to be a safe alternative to nadroparin for AC in patients undergoing brain tumor surgery or suffering from SAH. MDPI 2021-05-13 /pmc/articles/PMC8162528/ /pubmed/34067998 http://dx.doi.org/10.3390/neurolint13020021 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Wilhelmy, Florian
Hantsche, Annika
Gaier, Michael
Kasper, Johannes
Fehrenbach, Michael Karl
Oesemann, Rene
Meixensberger, Jürgen
Lindner, Dirk
Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery
title Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery
title_full Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery
title_fullStr Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery
title_full_unstemmed Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery
title_short Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery
title_sort tinzaparin vs. nadroparin safety and efficacy in neurosurgery
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8162528/
https://www.ncbi.nlm.nih.gov/pubmed/34067998
http://dx.doi.org/10.3390/neurolint13020021
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