Evidence map›Paper›PMID 31064405›Full record

Trial reportBMC pharmacology & toxicology2019

Evaluation of prophylactic dosages of Enoxaparin in non-surgical elderly patients with renal impairment.

Nibal Chamoun, Hady Ghanem, Ahmad Hachem, Essa Hariri, Christelle Lteif, Hanine Mansour, Hani Dimassi, Richard Zalloum, Georges Ghanem

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC pharmacology & toxicology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03158792 (Evaluation of Non-Surgical Venous Thromboembolism Prophylaxis Dosing Strategies), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03158792 phase4completednot on this map

Evaluation of Non-Surgical Venous Thromboembolism Prophylaxis Dosing Strategies: Enoxaparin 20mg Versus 30mg Subcutaneously Once Daily in Elderly Patients With Impaired Renal Function

TypeinterventionalSponsorLebanese American UniversityRan2015 to 2017Enrolled32ConditionsVenous Thromboembolism, Renal ImpairmentArmsEnoxaparin 20Mg/0.2mL Prefilled Syringe, Enoxaparin 60Mg/0.6Ml Inj Syringe 0.6Ml
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Nibal ChamounDepartment of Pharmacy Practice, School of Pharmacy, Lebanese American University, PO BOX 36, Byblos, Lebanon. nibal.chamoun@lau.edu.lb.ORCID 0000-0002-0987-296X
Hady GhanemHematology Oncology Division, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon.
Ahmad HachemPediatrics Division, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon.
Essa HaririDivision of Cardiology, University of Massachusetts Medical School, Worcester, MA, USA.
Christelle LteifDepartment of Pharmacy Practice, School of Pharmacy, Lebanese American University, PO BOX 36, Byblos, Lebanon.
Hanine MansourDepartment of Pharmacy Practice, School of Pharmacy, Lebanese American University, PO BOX 36, Byblos, Lebanon.
Hani DimassiDepartment of Pharmaceutical Sciences, School of Pharmacy, Lebanese American University, Byblos, Lebanon.
Richard ZalloumCardiology Division, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon.
Georges GhanemCardiology Division, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon.
Lebanese American University · LBUniversity Medical Center Rizk Hospital · LBAmerican University of Beirut Medical Center · LBUniversity of Massachusetts Chan Medical School · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThromboprophylaxis dosing strategies using enoxaparin in elderly patients with renal disease are limited, while dose adjustments or monitoring of anti-Xa levels are recommended. We sought to evaluate the efficacy and safety of enoxaparin 20 mg versus 30 mg subcutaneously daily by comparing anti-Xa levels, thrombosis and bleeding.

methodsWe conducted a prospective, single-blinded, single-center randomized clinical trial including non-surgical patients, 70 years of age or older, with renal disease requiring thromboprophylaxis. Patients were randomized to receive either 20 mg or 30 mg of enoxaparin. The primary endpoint was peak anti-Xa levels on day 3. Secondary endpoints included trough anti-Xa levels on day 3, achievement of within range prophylactic target peak anti-Xa levels and the occurrence of hemorrhage, thrombosis, thrombocytopenia or hyperkalemia during hospitalization.

resultsThirty-two patients were recruited and sixteen patients were randomized to each arm. Mean peak anti-Xa level was significantly higher in 30 mg arm (n = 13) compared to the 20 mg arm (n = 11) 0.26 ± 0.11, 95%CI (0.18-0.34), versus 0.14 ± 0.09, 95CI (0.08-0.19) UI/ml, respectively; p = 0.004. Mean trough anti-Xa level was higher in 30 mg arm (n = 10) compared to the 20 mg arm (n = 16), 0.06 ± 0.03, 95CI (0.04-0.08) versus 0.03 ± 0.03, 95CI (0.01-0.05) UI/ml, respectively; p = 0.044. Bleeding events reported in the 30 mg arm were one retroperitoneal bleed requiring multiple transfusions, and in the 20 mg arm one hematuria. No thrombotic events were reported.

conclusionPeak anti-Xa levels provided by enoxaparin 20 mg were lower than the desired range for thromboprophylaxis in comparison to enoxaparin 30 mg.

trial registrationThe trial was retrospectively registered on ClinicalTrials.gov identifier: NCT03158792 . Registered: May 18, 2017.

Indexed as

AgedAged, 80 and overAnticoagulantsEnoxaparinFactor XaFemaleHemorrhageHumansMaleRenal InsufficiencySingle-Blind MethodThrombosisTreatment OutcomeAnticoagulantsEnoxaparinFactor XaAnti-XaElderlyEnoxaparinRenal impairmentThromboprophylaxisVenous thromboembolism

Identifiers

PMID31064405
PMCPMC6505244
OpenAlexW2947672354

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.