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Do We Have the GUSTO to Identify Differences Between Alternative Formulations?

Arch Intern Med. 2005;165:722-723.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In this issue of the ARCHIVES, Wells et al¹ present data on the first randomized trial of 2 different formulations of low-molecular-weight heparin (LMWH). The question of whether these compounds are interchangeable is important for the treatment of venous thromboembolism as well as for thromboprophylaxis and treatment of acute coronary syndrome.

Low-molecular-weight heparins, first developed about 25 years ago, are a mixture of polysaccharides derived from unfractionated heparin by depolymerization. Each LMWH is prepared by a different depolymerization method—chemical, enzymatic, physical, or radiochemical. The 3 preparations currently approved by the US Food and Drug Administration for use in the United States are enoxaparin sodium, dalteparin sodium, and tinzaparin sodium. Although the molecular weight of unfractionated heparins ranges from 3000 to 30 000 Da, the LMWHs range from 2000 to 9000 Da, with a mean of around 5000 Da.² Heparin exerts its anticoagulant action by binding to antithrombin. This complex . . . [Full Text of this Article]

AUTHOR INFORMATION
Anaadriana Zakarija, MD; Charles L. Bennett, MD, PhD, MPP

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A Randomized Trial Comparing 2 Low-Molecular-Weight Heparins for the Outpatient Treatment of Deep Vein Thrombosis and Pulmonary Embolism
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