Display options
Share it on

J Pharm Health Care Sci. 2017 Jan 18;3:6. doi: 10.1186/s40780-017-0075-x. eCollection 2017.

Predictive factors for effectiveness and safety of enoxaparin for total knee arthroplasty in aged Japanese patients: a retrospective review.

Journal of pharmaceutical health care and sciences

Akihiro Sonoda, Yuki Kondo, Yasuhiro Tsuneyoshi, Yoshitaka Iwashita, Shoji Nakao, Kazuhisa Ishida, Kentaro Oniki, Junji Saruwatari, Tetsumi Irie, Yoichi Ishitsuka

Affiliations

  1. Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, Chuo-ku 862-0973 Japan.
  2. Department of Pharmacy, Izumi Regional Medical Center, 4513 Akasegawa, Akune, Kagoshima 899-1611 Japan.
  3. Department of Orthopedic Surgery, Izumi Regional Medical Center, 4513 Akasegawa, Akune, Kagoshima 899-1611 Japan.
  4. Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, Chuo-ku 862-0973 Japan.
  5. Center for Clinical Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Kumamoto, Chuo-ku 862-0973 Japan.

PMID: 28116117 PMCID: PMC5241995 DOI: 10.1186/s40780-017-0075-x

Abstract

BACKGROUND: The aims of this study were to investigate predictive factors involved in effectiveness and safety of enoxaparin for prevention of postoperative venous thromboembolism in aged Japanese total knee arthroplasty (TKA) patients.

METHODS: Japanese patients over 65 years old who were administered enoxaparin for TKA were enrolled in this study. Their medical records were retrospectively reviewed. Data were corrected at the Izumi Regional Medical Center, from September 2009 to March 2014. Patients were stratified into groups according to whether enoxaparin was effective (no deep vein thrombosis event up to postoperative day 7) or not, and whether they had an adverse drug event (ADE) or not.

RESULTS: A total of 128 patients were included in this study. One hundred five (82.0%) patients were in the effective group and 20 (15.6%) in the adverse drug event (ADE) group. Anemia (13 patients), abnormalities in liver function tests (4 patients), clinically relevant non-major bleeding (4 patients) and urticaria (1 patient) were observed as ADEs. Multivariate logistic regression analysis showed that the serum total protein level at postoperative day 1 (POD1, before enoxaparin administration), was associated with effectiveness of enoxaparin, while the serum total protein and hemoglobin level at POD1 were involved in ADE caused by enoxaparin.

CONCLUSIONS: Although further large scale studies will be warranted, our results suggest that serum total protein level just before enoxaparin treatment for TKA relates to the effectiveness and safety of enoxaparin in a Japanese aged population. In addition, the results indicate that the development of anemia should be carefully monitored during enoxaparin treatment for TKA, particularly in patients with lower levels of serum hemoglobin before treatment.

Keywords: Adverse drug event; Anemia; Enoxaparin; Serum total protein; Total knee arthroplasty; Venous thromboembolism

References

  1. Am J Crit Care. 2008 Nov;17(6):567-75 - PubMed
  2. Ther Drug Monit. 2004 Jun;26(3):284-6 - PubMed
  3. Lancet. 2010 Mar 6;375(9717):807-15 - PubMed
  4. J Clin Pharmacol. 2001 Jun;41(6):691-4 - PubMed
  5. Pathol Res Pract. 1994 Apr;190(4):394-9 - PubMed
  6. Medicine (Baltimore). 2016 Aug;95(31):e4489 - PubMed
  7. Science. 1988 Jun 3;240(4857):1285-93 - PubMed
  8. Thromb Res. 2002 Feb 1;105(3):201-4 - PubMed
  9. BMC Nephrol. 2012 Sep 10;13:107 - PubMed
  10. Ann Pharmacother. 1996 May;30(5):476-80 - PubMed
  11. Chest. 2008 Jun;133(6 Suppl):381S-453S - PubMed
  12. Aliment Pharmacol Ther. 2001 Feb;15(2):171-80 - PubMed
  13. Orthop Clin North Am. 2006 Oct;37(4):559-68 - PubMed
  14. Ann Pharmacother. 1999 Feb;33(2):236-40 - PubMed
  15. Arch Intern Med. 1997 Dec 8-22;157(22):2562-8 - PubMed
  16. Chest. 2008 Jun;133(6 Suppl):141S-159S - PubMed
  17. Int J Clin Pharm. 2015 Feb;37(1):23-6 - PubMed
  18. J Coll Physicians Surg Pak. 2014 Jul;24(7):455-8 - PubMed
  19. J Gastrointest Surg. 2007 Oct;11(10):1355-60 - PubMed
  20. J Thromb Haemost. 2008 Mar;6(3):405-14 - PubMed
  21. Osteoarthritis Cartilage. 2010 Jan;18(1):24-33 - PubMed
  22. Eur J Clin Pharmacol. 2001 Mar;56(12):935-41 - PubMed
  23. Clin Pharmacokinet. 2011 Feb;50(2):99-110 - PubMed
  24. Thromb Res. 2014 Jun;133(6):1016-22 - PubMed
  25. Am J Cardiovasc Drugs. 2001;1(6):477-81; discussion 483-4 - PubMed
  26. Chest. 2004 May;125(5):1616-21 - PubMed
  27. Drug Metab Rev. 1976;5(1):43-140 - PubMed
  28. Am J Med. 2002 Feb 15;112(3):247-8 - PubMed
  29. N Engl J Med. 2008 Jun 26;358(26):2776-86 - PubMed

Publication Types