Reviparin - A review of its efficacy in the prevention and treatment of venous thromboembolism

Reviparin (reviparin sodium) is a low molecular weight heparin (LMWH) that catalyses the inactivation of factors Xa and IIa by binding to antithrombin , which ultimately leads to the inhibition of the clotting cascade. It is a dministered subcutaneously. Reviparin 7000 to 12,600 anti-XaIU/day was found to be as effective as intr avenous unfractionated heparin in preventing the clinical recurrence of acu te deep vein thrombosis (DVT) and/or pulmonary embolism in 1 large randomis ed, multicentre trial(COLUMBUS) and was significantly more effective than i ntravenous unfractionated heparin in the prevention of recurrent venous thr omboembolism in another large randomised, multicentre trial (CORTES). Revip arin has also been compared with unfractionated heparin in children with es tablished DVT. However, the trial was under-powered and no conclusion could be made regarding comparative efficacy. As prophylaxis, reviparin 1750 anti-XaIU once daily was as effective as unf ractionated heparin 5000IU twice daily in 1311 patients undergoing abdomina l surgery and, in a once daily dosage of 4200 anti-XaIU, was as effective a s subcutaneous enoxaparin sodium 40 mg/day or acenocoumarol in patients und ergoing hip replacement surgery, Reviparin 1750 anti-XaIU also effectively prevented DVT. compared with no treatment, in patients undergoing knee arth roscopy. It was also more effective than placebo in patients with brace imm obilisation of the lower extremity, Reviparin was compared with 'standard c are' in children with central venous lines. However, the trial was too smal l to make conclusions regarding its efficacy.