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Fondaparinux and Prolonged Thromboprophylaxis After Hip Fracture Surgery—Reply
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In reply
My colleagues and I read with interest the comments of Dr Nurmohamed about the PENTHIFRA-Plus study.1 The importance of the duration of fondaparinux prophylaxis after major orthopedic surgery was first suggested in 4 previous short-term trials, since the efficacy of fondaparinux in preventing VTE was significantly related to the duration of its postoperative administration.2 Furthermore, in the 1-week PENTHIFRA trial in patients undergoing hip fracture surgery, 58.5% of fondaparinux-treated patients in whom a thromboembolic event did not occur received prolonged thromboprophylaxis with the investigators' choice of anticoagulant during follow-up.3 The PENTHIFRA-Plus study was the first trial to evaluate the benefit of extended thromboprophylaxis after hip fracture surgery. The incidence of VTE after 4-week fondaparinux therapy was therefore assumed on the basis of 2 previous long-term prophylaxis trials studying a low-molecular-weight heparin (LMWH) in a lower-risk group of patients undergoing elective hip replacement surgery.4-5 In the first of these . . . [Full Text of this Article]
Bengt I. Eriksson, MD, PhD
Göteborg, Sweden
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