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Evidence summaries

Subcutaneous Unfractionated Heparin for the Initial Treatment of Venous Thromboembolism

There may not be differences on the effectiveness of subcutaneous unfractionated heparin (UFH) compared to intravenous UFH or compared to LMWH for the treatment of venous thromboembolism. Level of evidence: "C"

The quality of evidence is downgraded by study limitations (unclear allocation concealment and lack of blinding), and by imprecise results (wide confidence intervals).

Summary

A Cochrane review [Abstract] 1 included 16 studies with a total of 3 593 subjects. 8 studies compared subcutaneous unfractionated heparin (UFH) to intravenous UFH; 7 studies subcutaneous UFH to LMWH; and 1 compared subcutaneous UFH to both intravenous UFH and subcutaneous LMWH for the initial treatment of venous thromboembolism. There were no differences between subcutaneous and intravenous UFH or between subcutaneous UFH and LMWH in the incidence of symptomatic recurrent VTE at 3 months, symptomatic recurrent deep vein thrombosis (DVT) at 3 months, pulmonary embolism (PE) at 3 months, VTE-related mortality at 3 months, major bleeding or all-cause mortality. There were no episodes of asymptomatic VTE occurring within 3 months of the commencement of treatment.

    References

    • Robertson L, Strachan J. Subcutaneous unfractionated heparin for the initial treatment of venous thromboembolism. Cochrane Database Syst Rev 2017;(2):CD006771. [PubMed].

Primary/Secondary Keywords