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Trousseau syndrome: management of refractory VTE.
Hematology Am Soc Hematol Educ Program
December 2024
Department of Medicine, Hematology Service, Memorial Sloan Kettering Cancer Center, New York, NY; and Weill Cornell Medical College, New York, NY.
Managing recurrent and refractory venous thromboembolism (VTE) in patients with cancer presents unique challenges. This review outlines the complexities and therapeutic strategies for recurrent VTE in cancer patients, which includes distinguishing thrombus acuity, differentiating between tumor and bland thrombi, and evaluating potential contributing factors including anticoagulant adherence, extrinsic tumor compression, drug interactions, and anticoagulant-specific considerations such as heparin-induced thrombocytopenia or antithrombin deficiency. Different anticoagulation strategies are discussed, including the administration of escalated-dose low molecular weight heparin (LMWH) as well as the indications and rationale for switching between direct oral anticoagulants or LMWH.
View Article and Find Full Text PDFPopulation pharmacokinetics and pharmacodynamics of edoxaban in pediatric patients.
CPT Pharmacometrics Syst Pharmacol
January 2025
Quantitative Clinical Pharmacology, Daiichi Sankyo Inc., Basking Ridge, New Jersey, USA.
Edoxaban is an orally active inhibitor of activated factor X (FXa). Population pharmacokinetic (PK) and pharmacodynamic (PD) analyses were performed to characterize the PK and PK-PD relationships of edoxaban in pediatric patients to identify the covariates that may contribute to inter-subject variability in PK and PD of edoxaban in pediatric patients, and to compare the PK and PD data between pediatric and adult patients. The pediatric PK of edoxaban was best described by a two-compartment model with transit compartments, first-order oral absorption, and linear elimination.
View Article and Find Full Text PDFFunctionally distinct anticoagulant mechanisms of endothelial cells.
Thromb Res
December 2024
Synapse Research Institute Maastricht, Kon. Emmaplein 7, 6217, KD, Maastricht, the Netherlands.
Antithrombin and tissue factor pathway inhibitor (TFPI) provide different anticoagulant mechanisms. Having established a potent anticoagulant role of cultured human umbilical vein endothelial cells in vessel-on-a-chip microfluidic models, we now investigated how these cells modulated thrombin generation under stasis through antithrombin and TFPI pathways. We observed that endothelial monolayers in 96 well-plates strongly delayed and suppressed the thrombin generation process induced by tissue factor, regardless of the presence of whole blood, platelet-rich plasma or platelet-free plasma.
View Article and Find Full Text PDFUK Foot and Ankle Thromboembolism (UK-FATE).
Bone Joint J
November 2024
York and Scarborough Hospitals NHS Trust, North Yorkshire, United Kingdom.
Article Synopsis
Comprehensive chromatographic profiling and structural analysis of key anticoagulant components in enoxaparin.
J Chromatogr A
November 2024
College of Pharmaceutical Sciences and Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases, Soochow University, Suzhou, Jiangsu 215021, China. Electronic address:
Heparin is the most widely used anticoagulant in clinical practice, with enoxaparin being one of the most important low molecular weight heparins (LMWHs). In this study, an antithrombin III (ATIII) affinity column was used. Enoxaparin and its oligosaccharides of varying sizes, prepared using preparative size exclusion chromatography (SEC), were fractionated through the ATIII affinity column.
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