Gras J
Drugs Today (Barc). 2012 Jul;48(7):451-7. doi: 10.1358/dot.2012.48.7.1838374.
Cancer-associated venous thromboembolism increases the morbidity and mortality in patients with cancer, being the second leading cause of death among these patients. As such, it has important clinical and economical consequences and current guidelines recommend thromboprophylaxis for cancer patients who are admitted to the hospital for medical illness or for major cancer surgery but not for routine use in ambulatory patients receiving chemotherapy. Semuloparin (AVE-5026) is a hemisynthetic, ultra-low-molecular-weight heparin, with high anti-factor Xa and residual antithrombin activities that was submitted for approval to the European Medicines Agency and the U.S. Food and Drug Administration in September 2011 for the prevention of venous thromboembolism in cancer patients. In a multicenter trial (SAVE-ONCO), once-daily, subcutaneous semuloparin at 20 mg administered to 1,608 patients receiving chemotherapy for locally advanced or metastatic solid tumors significantly prevented venous thromboembolism without increasing major bleeding, suggesting that semuloparin thrombo-prophylaxis can be beneficial in cancer patients receiving chemotherapy.
癌症相关的静脉血栓栓塞会增加癌症患者的发病率和死亡率，是这些患者的第二大死因。因此，它具有重要的临床和经济影响，目前的指南建议对因内科疾病或重大癌症手术入院的癌症患者进行血栓预防，但不建议在接受化疗的门诊患者中常规使用。赛莫肝素（AVE-5026）是一种半合成的超低分子量肝素，具有高抗Xa因子活性和残余抗凝血酶活性，于2011年9月提交给欧洲药品管理局和美国食品药品监督管理局批准，用于预防癌症患者的静脉血栓栓塞。在一项多中心试验（SAVE-ONCO）中，对1608例接受局部晚期或转移性实体瘤化疗的患者每日一次皮下注射20mg赛莫肝素，显著预防了静脉血栓栓塞，且未增加大出血风险，这表明赛莫肝素血栓预防对接受化疗的癌症患者可能有益。
