Once Daily Vs Twice Daily Low Molecular Weight Heparin (Lmwh) for Deep Vein Thrombosis
Once daily LMWH may be as effective as twice daily LMWH for deep vein thrombosis (DVT), but the number of symptomatic or recurrent DVT or death in the meta-analysis was too small for definitive conclusions. Level of evidence: "C"A topic in Clinical Evidence 1 summarizes the effect of once daily vs twice daily LMWH in DVT. According to a meta-analysis 2, there were 26/614 (4.2%) symptomatic DVTs in patients on once daily LMWH compared to 32/642 (5.1%) in patients with twice daily LMWH. At 10 days there were 7/750 deaths in patients with once daily LMWH vs 1/772 deaths in patients with twice daily LMWH. The mortality at 3 months was similar.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison, few outcome events) and by inconsistency.
References
- Fitzmaurice D, Hobbs FDR, McManus R. What are the effects of treatments for proximal deep vein thrombosis. Clinical Evidence 2004;12:297.
- Couturaud F, Julian JA, Kearon C. Low molecular weight heparin administered once versus twice daily in patients with venous thromboembolism: a meta-analysis. Thromb Haemost 2001 Oct;86(4):980-4. [PubMed]