Reaching a New APEX; Betrixaban vs. Enoxaparin for Thromboprophylaxis

Achal Patel, Mercer University College of Pharmacy

Venous thromboembolism (VTE) is the third leading cause of vascular diagnosis following heart attack and stroke. [1] It is categorized into two types: deep vein thrombosis (DVT) and pulmonary embolism (PE). Venous thromboembolism affects men and women of all ages, and patients that are immobilized are at a higher risk. [1]

The Chest Guidelines recommend anticoagulants for up to two weeks after hospital discharge. [2] However, the risk of a VTE remains increased for at least a month. Therefore, Bevyxxa® (betrixaban), which is a direct and selective factor Xa inhibitor, was tested for extended-duration therapy for thromboprophylaxis in acutely ill medical patients. [3]

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Enoxaparin for Prevention of Unexplained Recurrent Miscarriage: A Multicenter Randomized Double-Blind Placebo-Controlled Trial

Kingsley Onokalah, PharmD candidate 2015, Mercer University College of Pharmacy

Recurrent miscarriage is defined as three pregnancy losses before twenty weeks gestation.1  It occurs in 10% to 15% of pregnancies and recurs in 5% of subsequent pregnancies.  Pasquier et al state that many experts extend the definition of recurrent miscarriage to two pregnancy losses since the recurrence rate is similar to that of three losses.2

Recurrent miscarriage may be attributed to numerous factors, including antiphospholipid syndrome, thrombophilias, hormonal or metabolic disorders, infection, genetics, and age.1  Per the Practice Committee of the American Society for Reproductive Medicine, most miscarriages occur intermittently and are thought to result from genetic causes that are mostly influenced by maternal age.3

According to a review of nine studies conducted by de Jong et al examining the use of anticoagulants in women with recurrent miscarriages with or without inherited thrombophilia, evidence does not support the use of anticoagulants with idiopathic recurrent pregnancies.4

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Factor XI Antisense Oligonucleotide for Prevention of Venous Thrombosis

LanAnh Ngo, PharmD Candidate 2015 Mercer University College of Pharmacy

Current antithrombotic therapies have significant impacts on patient outcomes. These therapies are important in many different types of settings, but is often associated with a risk of bleeding. An emerging new target of therapy, factor XI antisense oligonucleotide, functions to reduce the levels of factor XI, thereby reducing levels of thrombosis, but without the risk of bleeding.1

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