Heparinoid

In evaluating this drug, 1 case of contact allergy among 513 patients treated was observed (Schone 1975). 

---

Cytotoxic Agents Cytotoxic T-cells Danaparoid (Heparinoid)... 

The multiple effects of UFH on the coagulation cascade may increase its potential to cause hemorrhage." Anticoagulants with more specific sites of action may confer a better safety profile. Two such anticoagulants are low-molecular-weight heparin (LMWH) and heparinoids. 

Heparinoid is a term used to describe naturally occurring and synthetic glycosoaminoglycans of structure similar to heparin. Heparinoids have specific... 

Placebo-Controlled Trials ofUFH, LMWH, and Heparinoids The International Stroke Trial (1ST) was a randomized, placebo-controlled trial of UFH (5000 or 12,500 lU twice daily) and aspirin (300 mg) in 19,435 unselected patients with acute stroke within 48 hours of symptom onset. Because of limited availability of neuroimaging, 33% of participants were enrolled with suspected but not proven ischemic stroke, some of whom may have suffered primary intracerebral hemorrhage (ICH). 

One meta-analysis examined the safety and efficacy of LMWH and heparinoids in 11 randomized trials of 3048 patients with acute ischemic stroke. It reported a reduction in the incidence of deep venous thrombosis (DVT) (odds ratio (OR) 0.27,... 

Trials of Unfractionated Heparin Compared to LMWH and Heparinoids... 

Relatively few data exist concerning the relative benefits of UFH, LMWH, and heparinoids in acute stroke treatment. In 2005, the Cochrane Collaboration reviewed trials comparing LMWHs or heparinoids with UFH in acute ischemic... 

Groups assigned to a LMWH or heparinoid had a significant reduction in the odds of DVT (OR 0.52, 95% Cl 0.56-0.79). However, there were too few major events (PE, death, intracranial or extracranial hemorrhage) to provide a reliable estimate of other benefits or risks. 

For patients with Acute Ischemic Stroke they recommend clinicians not to use full-dose anticoagulation with IV, subcutaneous, or low-molecular-weight heparins or heparinoids (grade 2B evidence). 

There is no recommendation for general use of heparin, low-molecular-weight heparin, or heparinoids after ischemic stroke (Level of Evidence I). 

Gordon DL, Linhardt R, Adams HP. Low molecular-weight heparins and heparinoids and their use in acute or progressing ischemic stroke. Clin Neuropharmacol 1990 13 522-543. 

Publications Committee for the Trial of Org 10172 in Acute Stroke Treatment (TOAST) Investigators. Low molecular weight heparinoid ORG 10172 (Danaparoid) and outcome after acute ischemic stroke. JAMA 1998 279 1265-1272. 

Bath P, Iddenden R, Bath F. Low-molecular-weight heparins and heparinoids in acute ischemic stroke, a meta-analysis of randomised controlled trials. Stroke 2000 31 1770-1778. 

Sandercock P, Counsell C, Stobbs SL. Low-molecular-weight heparins or Heparinoids versus standard Unfractionated heparin for acute ischemic stroke (Review). The Cochrane Collaboration 2006. 

Low-molecular-weight heparins and heparinoids are not recommended in the treatment of acute ischemic stroke.11 A meta-analysis was performed using data from 10 randomized controlled trials.19 A non-significant decrease in combined death and disability and a non-significant increase in case fatality and hemorrhage were seen. A reduction in venous thromboembolic events was observed in acute stroke patients however, there was also an increase in extracranial bleeding. 

The importance of anionic charge-density is emphasized by the biological activities of heparin fractions having low affinity for antithrombin,496,497 and of heparinoids.10 Although consistently lower than ob-... 

The use of full-dose unff actionated heparin in the acute stroke period has not been proven to positively affect stroke outcome, and it significantly increases the risk of intracerebral hemorrhage. Trials of low-molecular-weight heparins and heparinoids have been largely negative and do not support their routine use in stroke patients. 

When neuraxial anesthesia (epidural/spinal anesthesia) or spinal puncture is employed, patients who are anticoagulated or scheduled to be anticoagulated with low molecular weight heparins (LMWHs) or heparinoids for prevention of thromboembolic complications are at risk of developing an epidural or spinal hematoma, which can result in long-term or permanent paralysis. 

---